You are caring for an 11-year-old girl with Acute Lymphoblastic Leukemia (ALL). She is inpatient receiving chemotherapy and has developed mucositis. Select which nursing interventions you would anticipate for this patient. Select THREE that apply.

Rationale: A. Perform meticulous oral care with a hard bristled toothbrush: A hard bristled toothbrush can easily damage the delicate and inflamed mucosa in a patient with mucositis, increasing pain, risk of bleeding, and potential entry points for infection. Using a soft-bristled toothbrush is safer. B. Initiate NPO orders to minimize pain: Avoiding food altogether is generally not beneficial unless swallowing is unsafe, as it can lead to malnutrition and dehydration. Managing pain and modifying the diet is preferred so the patient can continue to receive nutrition and fluids. C. Administer a mouthwash with numbing and antibacterial agents: These solutions help reduce discomfort during eating and oral care while lowering bacterial load in the mouth, which is important for infection prevention in immunocompromised patients. D. Encourage a soft, bland diet and proper hydration: Soft, mild foods are less abrasive to oral tissues, and adequate fluid intake supports tissue healing and overall recovery. Eliminating rough, acidic, or spicy foods can help avoid worsening mucosal irritation. E. Monitor for rectal involvement and administer stool softeners: Mucositis can affect the gastrointestinal tract beyond the mouth, leading to painful or fragile rectal mucosa. Stool softeners reduce the risk of trauma from straining during bowel movements, helping to prevent bleeding and discomfort.