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  • Look

    Does the patient appear uncomfortable? Does the patient appear unwell? Difficulty talking? Licking lips to moisten often? Weight loss? Does the patient appear dehydrated? Does the patient have thrush?

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  • Listen

    Does the patient report? Mouth pain (tongue, gums, buccal mucosa) Mouth sores Difficulty eating Waking during the sleep to sip water Recent dental-related issues Need for dental work (e.g., root canal, tooth extraction) Have symptoms worsened?

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  • Recognize

    A history of mouth sores Does patient smoke? Concomitant medications associated with causing dry mouth? Reports of dry mouth often accompany mucositis Other reports of dry membranes (e.g., eyes, nasal passages, vagina)

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  • Recognize

    Is there a history of dermatitis, pre-existing skin issues (psoriasis, wounds, etc.)? Laboratory abnormalities consistent with other etiologies (e.g., eosinophils on complete blood count, liver function abnormalities)

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  • Listen

    Does the patient have pruritus with or without rash? Is there a rash with or without pruritus? Are symptoms interfering with ADLs? With sleep? Have symptoms worsened?

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  • Look

    Does the patient appear uncomfortable? Does the patient appear unwell? Is there an obvious rash? Is the patient scratching during the visit? Is skin integrity intact? Are there skin changes? Xerosis Changes in skin pigment or color Is there oral involvement of the rash?

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  • Recognize

    Serum chemistry/hematology abnormalities Infectious vs immune-related adverse event causation Peritoneal signs of bowel perforation (i.e., pain, tenderness, bloating)

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  • Listen

    Quantity & quality of bowel movements (e.g., change in/increased frequency over baseline): solid, soft, or liquid diarrhea; dark or bloody stools; or stools that float Fever Abdominal pain or cramping Increased fatigue Upset stomach, nausea, or vomiting Bloating/increased gas Decreased appetite or food aversions

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  • Look

    Does the patient appear weak? Has the patient lost weight? Does the patient appear dehydrated? Does the patient appear in distress?

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