Which of the following conditions are NOT treated with CAR T-cell therapy?
Aplastic anemia
Lymphoma
Acute Lymphoblastic Leukemia
Multiple Myeloma
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?
Tell the patient to go to the ED immediately.
Tell the patient to take Tylenol and call back in 8 hours.
Instruct the patient to come to the hospital. Call the MD.
Document the call and hang up.
Prior to the administration of CAR T therapy, the facility must have at LEAST ___ doses of Tocilizumab available.
4
1
12
2
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?
T-cell battering therapy
CAR B-cell therapy
CAR battery therapy
CAR T-cell therapy
During the 2200 telehealth visit the patient experiences a seizure witnessed by the nurse. What action should the nurse take?
Panic.
Tell the patient to take more Keppra.
End the call promptly and wake the attending.
Stay on the call. Ask caregiver to call 911. RN call MD.
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"
"As soon as the benadryl wears off"
"At least 4 months"
Where do the T-cells come from that are engaged in BiTE therapy?
A friend of a friend's T-cells
A donor's T-cells
They are harvested from actual bite wounds
The patient's own T-cells
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?
Give steroids and turn down the infusion.
Continue to monitor the patient.
Give tylenol & tocilizumab, transfer to ICU for vasopressors
Give a 3rd bolus and ibuprofen.
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?
Complete the ICANS assessment by assigning a grade.
Ask the medical student to round on this patient 1st.
Reorient the patient and reassess after coaching them.
Wait 6 hours and rescreen the patient.
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 4
Grade 2
Grade 0
Grade 1
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 10
Grade 4
Grade 3
Grade 2
The nurse is completing the ICE assessment on a patient that has received IEC therapy. What is a "perfect" ICE score?
10
100
50
1
What is the BEST thing a nurse can do to recognize and intervene for IEC related adverse effects?
Infrequent assessments with CRP and ICAN'T screening tools.
Facebook thoughts and prayers.
Frequent assessments with CRS & ICE/ICANS screening tools.
Remind the attending physician every hour to assess the pt.
Which statement about CAR T-cell therapy is FALSE?
CAR T-cells can be directed to specific antigens
It creates immediate graft versus host disease
Useful in treating chemo refractory disease
Can be used independent of or in addition to a BMT
The nurse asks the patient to write the standard sentence on the CAR T writing log. How should the nurse assist the patient?
Tap and shout what to write on the paper.
Sit the pt upright. Turn lights on. Hard writing surface.
The patient is on their own for this.
Hold their hand while writing.
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 0
Grade 2
Grade 4
Grade 6
Patients that receive immune effector cell therapy are most at risk for which 2 serious side effects?
Cytokine Release Syndrome & neurologic toxicities
There are NO side effects.
Sickle cell conversion & myeloablation
Cytokine Restraint Sickness & nephrotoxicity
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?
Scold the patient for doing it wrong.
Score as 0 on the ICE assessment, complete ICANS, call MD.
Congratulate the patient on a job well done.
Score as -1 on the ICE assessment, complete the EWS.
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 2
Grade 3
Grade 1
Grade 0
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?
3
1
10
7