Clinical meaning
Huntington disease (HD) is a progressive neurodegenerative disorder caused by a CAG trinucleotide repeat expansion in the huntingtin gene on chromosome 4 (autosomal dominant inheritance). The disease manifests in three domains: motor (chorea → rigidity), cognitive (subcortical dementia with executive dysfunction), and psychiatric (depression, irritability, apathy). Nursing management focuses on safety, symptom management, nutritional support, and psychosocial care across the disease trajectory. Chorea (involuntary, dance-like movements) creates significant fall risk requiring environmental modifications and mobility aids. As the disease progresses, chorea decreases but rigidity and dystonia increase, eventually leading to immobility. Dysphagia is a critical nursing concern because aspiration pneumonia is the leading cause of death. Regular swallowing assessments, modified diet textures, proper positioning during meals (upright, chin tuck), and monitoring for aspiration signs (coughing/choking during meals, wet/gurgly voice, recurrent pneumonia) are essential. Weight loss from hypermetabolism (constant involuntary movement burns additional calories) requires high-calorie supplementation. Psychiatric symptoms — particularly depression (40%) and suicide risk (5-10× general population) — require ongoing screening and intervention. Early advance care planning is essential while the patient retains decision-making capacity.