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

  1. Neurologic status, noting uncontrolled movements and cognitive ability.
  2. Family history of Huntington’s chorea.

Nursing Diagnoses

  1. Risk for aspiration
  2. Body image disturbance
  3. Bowel incontinence
  4. Risk for injury
  5. Altered nutrition less than body requirements
  6. Self-care deficit
  7. Risk for impaired skin integrity
  8. Impaired swallowing
  9. Altered thought process
  10. Impaired verbal communication

Therapeutic Interventions

  1. Control of jerky movements with phenothiazines, butyrophenones, and thioxanthenes.
  2. Reserpine may be used to decrease presynaptic dopamine and tetrabenzine to reduce dopaminergic transmission.
  3. Symptoms are treated as they occur.

Nursing Interventions

  1. Provide emotional support for client and family.
  2. Allow client and family to express feelings about progressive deterioration and ultimate death.
  3. Encourage family members to seek genetic counseling.
  4. Modify environment to increase safety.
  5. Assess ability to swallow.
  6. Provide nutritional support as needed.
  7. Encourage client to remain as active as possible.
  8. Provide respiratory support based on changing needs of client such as airway, suctioning, oxygenation).
  9. 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.

What Do You Think?