Nursing Strategies for Managing irAEs

CE / CME

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

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

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

Released: April 21, 2025

Expiration: October 20, 2025

Pretest

Progress
1 2 3
Course Completed
Please answer the questions below.
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?