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Nursing Strategies for Managing irAEs

CE / CME

Strengthening the Safety Net With Advanced Nursing Strategies for Managing Immunotherapy-Related Adverse Events

Physician Assistants/Physician Associates: 1.00 AAPA Category 1 CME credit

Nurse Practitioners/Nurses: 1.00 Nursing contact hours, includes 1.00 hour of pharmacotherapy credit

Released: April 21, 2025

Expiration: October 20, 2025

Pretest

Progress
1 2
Course Completed
1.

Your patient will be receiving an immune checkpoint inhibitor plus chemotherapy for stage IIIB NSCLC. Which of the following should you tell him/her may be AE experienced by patients receiving chemoimmunotherapy and should be reported to their HCP?

2.

Patient Case 1: 65-Yr-Old Woman Receiving Pembrolizumab/Axitinib for Metastatic RCC



  • A 65-yr-old woman is receiving pembrolizumab/axitinib for metastatic RCC

  • 2 wk after starting treatment, she develops diarrhea, and her stool frequency increases from a baseline of 2 stools/day to 5-6 stools/day

  • She is experiencing some mild abdominal discomfort (cramping), but her appetite remains good  

What would be the optimal first step in generating a proactive nursing care plan for this patient who just started pembrolizumab/axitinib therapy and develops signs of grade 2 diarrhea/colitis?

3.

Patient Case 2: 60-Yr-Old Retired Carpet Layer



  • Patient is a 60-yr-old male retired carpet layer

  • Patient has a history of tobacco use, BPH, HTN, COPD

    • He has metastatic adenocarcinoma NSCLC with a KRASG12C mutation and PD-L1 20%

    • He was treated with carboplatin, pemetrexed, and pembrolizumab, then transitioned to maintenance pemetrexed/pembrolizumab

    • After his second dose of maintenance therapy, he was hospitalized for pancytopenia, cellulitis, and disseminated VZV

    • Pemetrexed was discontinued and he continued on pembrolizumab monotherapy



  • Patient developed hyperthyroidism 5 mo after starting treatment with a suppressed TSH <0.01 mIU/L, but was asymptomatic  

Your patient is experiencing asymptomatic hyperthyroidism (suppressed TSH: <0.01 mIU/L) 5 mo after starting treatment with carboplatin, pemetrexed, and pembrolizumab, followed by maintenance pemetrexed and pembrolizumab. What should we do for this patient next?