The nurse asks the patient to write the standard sentence on the CAR T writing log. How should the nurse assist the patient?
Hold their hand while writing.
The patient is on their own for this.
Sit the pt upright. Turn lights on. Hard writing surface.
Tap and shout what to write on the paper.
A patient that has received CAR T-cell therapy today asks the nurse when they can drive again. Which answer by the nurse is correct?
"Never"
"At least 8 weeks"
"At least 4 months"
"As soon as the benadryl wears off"
Which statement about CAR T-cell therapy is FALSE?
It creates immediate graft versus host disease
CAR T-cells can be directed to specific antigens
Can be used independent of or in addition to a BMT
Useful in treating chemo refractory disease
The nurse is completing the ICE assessment on a patient that has received IEC therapy. What is a "perfect" ICE score?
1
100
10
50
Patients that receive immune effector cell therapy are most at risk for which 2 serious side effects?
Cytokine Restraint Sickness & nephrotoxicity
Cytokine Release Syndrome & neurologic toxicities
There are NO side effects.
Sickle cell conversion & myeloablation
A patient that has received CAR T therapy has a CRS grade of 2 (temp 100.9*F, BP 88/48) and is not responding to the 2nd 1000 mL fluid bolus. Which orders would the nurse anticipate?
Continue to monitor the patient.
Give tylenol & tocilizumab, transfer to ICU for vasopressors
Give a 3rd bolus and ibuprofen.
Give steroids and turn down the infusion.
What is the BEST thing a nurse can do to recognize and intervene for IEC related adverse effects?
Facebook thoughts and prayers.
Remind the attending physician every hour to assess the pt.
Infrequent assessments with CRP and ICAN'T screening tools.
Frequent assessments with CRS & ICE/ICANS screening tools.
The nurse completes the ICE assessment and the patient scores 3. The patient awakens to light sternal rub and has no seizures or other notable neurologic deficits. What grade is their ICANS?
Grade 4
Grade 2
Grade 10
Grade 3
Which of the following conditions are NOT treated with CAR T-cell therapy?
Aplastic anemia
Multiple Myeloma
Acute Lymphoblastic Leukemia
Lymphoma
The nurse is completing the ICE assessment on a patient that has received IEC therapy. Abnormals: patient states the year is 2016, they identify 2 out of 3 objects correctly and they can't count backwards from 100. What is their ICE score?
7
1
3
10
What therapy uses autologous T-cells engineered to express a specific T-cell receptor that makes the T cells recognize tumor cells and destroy them?
CAR battery therapy
T-cell battering therapy
CAR T-cell therapy
CAR B-cell therapy
A patient has completed IEC therapy. Their VS are: T - 99.1*F, P 96, BP 104/70, O2 sat 98% on RA. Grade the CRS.
Grade 4
Grade 2
Grade 6
Grade 0
The nurse is completing the ICE assessment on a patient that has received IEC therapy. The patient does not get a perfect score. What does the nurse do NEXT?
Wait 6 hours and rescreen the patient.
Ask the medical student to round on this patient 1st.
Reorient the patient and reassess after coaching them.
Complete the ICANS assessment by assigning a grade.
The nurse completes the ICE assessment and the patient scores 7. The patient awakens spontaneously and has no seizures or other notable neurologic deficits. What grade is their ICANS?
Grade 3
Grade 1
Grade 2
Grade 0
The nurse is conducting a telehealth visit with a patient that has received CAR T therapy. The ICE score is 10. The VS are: T 100.6, P 102, BP 108/62. What should the nurse do next?
Instruct the patient to come to the hospital. Call the MD.
Tell the patient to take Tylenol and call back in 8 hours.
Document the call and hang up.
Tell the patient to go to the ED immediately.
The nurse asks the patient to write the standard sentence on the CAR T writing log. Upon viewing the writing log what should the nurse do NEXT?
Score as -1 on the ICE assessment, complete the EWS.
Score as 0 on the ICE assessment, complete ICANS, call MD.
Congratulate the patient on a job well done.
Scold the patient for doing it wrong.
Where do the T-cells come from that are engaged in BiTE therapy?
They are harvested from actual bite wounds
The patient's own T-cells
A donor's T-cells
A friend of a friend's T-cells
A patient completed IEC therapy 4 days ago. Their VS are T - 101*F, P 112, BP 100/56, O2 Sat 93% on 2L via NC. Grade the CRS
Grade 0
Grade 2
Grade 1
Grade 4
Prior to the administration of CAR T therapy, the facility must have at LEAST ___ doses of Tocilizumab available.
1
4
12
2
During the 2200 telehealth visit the patient experiences a seizure witnessed by the nurse. What action should the nurse take?
End the call promptly and wake the attending.
Stay on the call. Ask caregiver to call 911. RN call MD.
Panic.
Tell the patient to take more Keppra.