Huntington’s Chorea
- Chorea, the Greek word meaning “dance”.
- It is described as involuntary movements of the body.
- Is a progressive neurodegenerative genetic disorder that affects muscle coordination.
Etiology and Pathophysiology
- Memory loss
- Disorientation
- Eventual dementia
- Uncontrolled jerky movements of the extremities, trunk, face, or tongue.
- Disorganized gait
- Uncontrolled periods of anger
- Hesitant or explosive pattern of speech
- Grimacing facial movements
- Impaired chewing and swallowing
- Incontinence
Assessment
- Neurologic status, noting uncontrolled movements and cognitive ability.
- Family history of Huntington’s chorea.
Nursing Diagnoses
- Risk for aspiration
- Body image disturbance
- Bowel incontinence
- Risk for injury
- Altered nutrition less than body requirements
- Self-care deficit
- Risk for impaired skin integrity
- Impaired swallowing
- Altered thought process
- Impaired verbal communication
Therapeutic Interventions
- Control of jerky movements with phenothiazines, butyrophenones, and thioxanthenes.
- Reserpine may be used to decrease presynaptic dopamine and tetrabenzine to reduce dopaminergic transmission.
- Symptoms are treated as they occur.
Nursing Interventions
- Provide emotional support for client and family.
- Allow client and family to express feelings about progressive deterioration and ultimate death.
- Encourage family members to seek genetic counseling.
- Modify environment to increase safety.
- Assess ability to swallow.
- Provide nutritional support as needed.
- Encourage client to remain as active as possible.
- Provide respiratory support based on changing needs of client such as airway, suctioning, oxygenation).
- Utilize community agencies to provide emotional support.
Complications
- Weight loss
- Pneumonia
- Congestive heart failure
- Incapacitated
- Bed sore
Daisy Jane Antipuesto RN MN
Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.
