What is a potential consequence of fistula output exceeding 200 mL over 24 hours?

When managing patients with fistulas, monitoring the output is crucial because excessive output can lead to several complications. If the output from the fistula exceeds 200 mL over a 24-hour period, one serious potential consequence is the occurrence of severe metabolic disturbances. This is primarily due to the loss of not only fluid but also essential electrolytes in the output.

In this context, metabolic disturbances may arise from the significant loss of sodium, potassium, and other electrolytes which are vital for maintaining cellular function and overall homeostasis in the body. When these electrolytes are depleted, it can lead to complications such as changes in muscle function, cardiac instability, and overall systemic impact that can manifest as symptoms like vomiting, weakness, arrhythmias, or altered mental status.

While dehydration and electrolyte imbalance are important considerations, the phrase "severe metabolic disturbances" encapsulates a wider range of possible pathological changes due to the cumulative effect of electrolyte loss and dehydration resulting from excessive fistula output. These can be immediate and serious, requiring prompt medical intervention. Thus, the correct answer highlights the gravity of monitoring and managing excess output from fistulas effectively to prevent such severe complications.