Stomatitis

Stomatitis belongs to digestive and hepatobiliary nursing because it can affect nutrition, hydration, pain control, drug metabolism, elimination and infection prevention.

In Diploma in Nursing (Direct) - DND 123: Medical Nursing (I) and Pharmacology (I), study stomatitis by linking the disease process to the patient's symptoms, the nurse's observations, immediate comfort needs, medicines or procedures ordered, and prevention of complications.

• Contributing factors may include infection, alcohol use, unsafe food or water, medicine irritation, gallstones, chronic viral disease or delayed review.
• Nutritional status, hygiene, concurrent medicines and previous abdominal illness influence severity and recovery.
• Hepatobiliary disease may change bleeding risk, mental state and the body's handling of medicines.

• Assess pain site and character, vomiting, stool changes, appetite, hydration, weight change, fever and abdominal distension.
• Observe jaundice, pallor, bleeding tendency, altered mental state, dark urine, pale stool or signs of shock.
• Review medicine use, alcohol history, food exposure, contact history and previous similar episodes.

• Prioritise airway, breathing, circulation, pain, hydration, nutrition, elimination, mobility, skin integrity and psychological support.
• Position the patient for comfort and safety, maintain privacy, reduce anxiety and involve the family where appropriate.
• Administer prescribed treatment safely, observe response and report deterioration early.
• Maintain infection-prevention measures, especially hand hygiene, safe waste handling, cough etiquette and appropriate isolation where indicated.
• Document assessment findings, interventions, patient response, education given and referral decisions clearly.

• Check allergies, pregnancy status where relevant, current medicines, vital signs and contraindications before giving ordered medicines.
• Explain the purpose of each medicine in simple language and observe for expected benefit and adverse effects.
• Encourage adherence, completion of prescribed courses and follow-up review, especially for chronic disease or infectious conditions.
• Escalate when symptoms worsen despite treatment, when side effects are severe, or when the patient cannot access essential medicines.

• Teach the patient and family what stomatitis means, the warning signs to report and the reason for follow-up.
• Use practical messages about hygiene, nutrition, safe medicines, rest, activity, fluid intake, avoidance of triggers and early review.
• Check understanding by asking the patient to repeat the plan in their own words.
• Adapt teaching to literacy level, language, culture, cost, distance from care and available family support.

Possible complications include bleeding, perforation, dehydration, malnutrition, hepatic failure, sepsis, electrolyte imbalance or severe pain.

• Seek urgent review for collapse, severe breathlessness, chest pain, confusion, convulsions, persistent high fever, uncontrolled bleeding, severe dehydration or rapidly worsening weakness.
• Refer early when the condition is beyond the facility's staffing, medicines, oxygen, laboratory or monitoring capacity.

• Use available facility protocols and current Uganda Clinical Guidelines when deciding referral urgency, ordered investigations and treatment support.
• Consider affordability, transport, medicine availability, stigma and family roles when planning discharge teaching.
• For communicable diseases, combine bedside care with contact advice, prevention messages and public-health reporting where required.
• For chronic diseases, focus on long-term adherence, lifestyle support, appointment keeping and recognition of relapse or complications.

• Revise stomatitis by connecting the affected body system, causes, risk factors and early findings.
• Prioritize the first-hour nursing actions, monitoring needs and escalation points.
• Link patient teaching to prevention, home care, adherence and follow-up.
• Keep danger signs and referral triggers visible during ward review.