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학습 자료 둘러보기 →In a patient with acute myeloid leukemia (AML) and hyperleukocytosis, new neurological symptoms like headache and visual changes must trigger an immediate assessment for leukostasis. The most critical finding is a change in neurological status, specifically altered mental status (confusion, lethargy, stupor).
This finding signals progression from focal symptoms to global cerebral hypoperfusion caused by WBC plugs in the microvasculature. It is a late and immediately life-threatening sign that precedes respiratory failure and death, requiring urgent leukapheresis or high-dose chemotherapy.
Do not attribute altered mental status to pain, anxiety, or fatigue in this high-risk population. A WBC count >100,000/µL is a critical threshold, but symptoms of leukostasis can occur at lower counts. Immediate notification of the provider and preparation for emergent intervention is the priority nursing action.
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