Wound, Ostomy and Continence Nurses Society (WOCN) Practice Exam

What indicates progress in healing a fistula?

1. Increased fistula output

2. Decreased distal bowel output

3. Decreased fistula output

4. Increased hunger and appetite

The correct answer is: Decreased fistula output

In the context of healing a fistula, a decrease in fistula output is a significant indicator of progress. This decrease suggests that the body is beginning to manage the flow of substances more effectively, which can align with healing processes. When a fistula is active, it often results in high output, which can lead to complications such as dehydration, electrolyte imbalances, and nutritional deficiencies. Therefore, as the healing process takes place, a reduction in output signifies that the connection between the bowel and the fistula is becoming less active, indicating improvement in the condition. Other options, such as increased fistula output or decreased distal bowel output, do not signify healing. Increased fistula output can suggest ongoing damage or complications, while decreased distal bowel output might not directly correlate with a change in fistula status. Increased hunger and appetite alone are not reliable indicators of fistula healing since they could be influenced by a variety of factors unrelated to the functionality of the fistula itself. Overall, a decrease in fistula output is a clear and direct sign of healing progress.