nursing diagnosis for gonorrhea

Gonorrhea Nursing Diagnosis & Care Plan

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Gonorrhea is a common sexually transmitted infection (STI) caused by the bacterium Neisseria gonorrhoeae. This nursing diagnosis focuses on identifying symptoms, preventing complications, and providing comprehensive care while preventing transmission to others.

Causes (Related to)

Gonorrhea can affect patients in various ways, with several factors contributing to its transmission and progression:

  • Bacterial infection caused by N. gonorrhoeae
  • Unprotected sexual contact with infected partner
  • Multiple sexual partners
  • Previous history of STIs
  • High-risk behaviors such as:
    • Inconsistent condom use
    • Drug or alcohol use affecting judgment
    • Sex work
    • Early sexual debut
  • Contributing factors including:
    • Limited access to healthcare
    • Poor health literacy
    • Socioeconomic barriers
    • Lack of regular STI screening

Signs and Symptoms (As evidenced by)

Gonorrhea presents with distinctive signs and symptoms that nurses must recognize for proper diagnosis and treatment.

Subjective: (Patient reports)

  • Painful or burning sensation when urinating
  • Increased vaginal/penile discharge
  • Vaginal/penile itching or burning
  • Lower abdominal pain
  • Painful intercourse
  • Testicular pain (in males)
  • Irregular menstrual bleeding (in females)
  • Joint pain
  • Throat pain (in cases of oral infection)

Objective: (Nurse assesses)

  • Purulent discharge from genitals
  • Cervical friability
  • Urethral inflammation
  • Epididymitis in males
  • Cervicitis in females
  • Fever (if PID develops)
  • Swollen lymph nodes
  • Conjunctivitis (if eye infection)
  • Skin rashes or lesions

Expected Outcomes

The following outcomes indicate successful management of gonorrhea:

  • The patient will complete the prescribed antibiotic treatment
  • The patient will demonstrate an understanding of safe sex practices
  • The patient will maintain sexual abstinence during treatment
  • The patient will notify sexual partners of exposure
  • The patient will return for follow-up testing
  • The patient will demonstrate knowledge of prevention strategies
  • The patient will remain infection-free after treatment

Nursing Assessment

Complete Sexual Health History

  • Document sexual practices and partners
  • Assess risk factors
  • Review previous STI history
  • Note current symptoms
  • Check vaccination status

Physical Assessment

  • Examine affected areas
  • Document discharge characteristics
  • Note the presence of inflammation
  • Assess for complications
  • Check for systemic symptoms

Psychosocial Assessment

  • Evaluate emotional response
  • Assess support system
  • Document relationship status
  • Evaluate barriers to treatment

Complication Screening

  • Monitor for PID signs
  • Assess for disseminated infection
  • Check for pregnancy status
  • Evaluate for co-infections
  • Document allergies

Prevention Assessment

  • Review safe sex knowledge
  • Assess barrier method use
  • Document partner notification plan
  • Evaluate follow-up capabilities
  • Check resources for treatment

Nursing Care Plans

Nursing Care Plan 1: Risk for Infection Transmission

Nursing Diagnosis Statement:
Risk for Infection Transmission related to sexually transmitted bacterial infection as evidenced by active gonorrhea infection.

Related Factors:

  • Active bacterial infection
  • Potential for unprotected sexual contact
  • Knowledge deficit regarding transmission
  • Multiple sexual partners

Nursing Interventions and Rationales:

  1. Implement contact precautions
    Rationale: Prevents transmission to healthcare workers and others
  2. Educate about sexual abstinence during treatment
    Rationale: Prevents transmission to partners and reinfection
  3. Teach proper condom use
    Rationale: Reduces risk of future STI transmission
  4. Assist with partner notification
    Rationale: Ensures exposed partners receive treatment

Desired Outcomes:

  • The patient will complete antibiotic treatment as prescribed
  • The patient will abstain from sexual activity during the treatment
  • The patient will demonstrate proper condom use
  • The patient will notify all sexual partners of the exposure

Nursing Care Plan 2: Knowledge Deficit

Nursing Diagnosis Statement:
Knowledge Deficit related to gonorrhea infection, treatment, and prevention as evidenced by limited understanding of transmission and prevention methods.

Related Factors:

  • Limited health literacy
  • Misconceptions about STIs
  • Lack of previous health education
  • Cultural or language barriers

Nursing Interventions and Rationales:

  1. Provide education about gonorrhea
    Rationale: Increases understanding of condition and treatment
  2. Demonstrate preventive measures
    Rationale: Enhances ability to prevent future infections
  3. Review medication instructions
    Rationale: Ensures proper treatment adherence

Desired Outcomes:

  • The patient will verbalize understanding of gonorrhea transmission
  • The patient will demonstrate knowledge of prevention methods
  • The patient will correctly explain the treatment plan

Nursing Care Plan 3: Acute Pain

Nursing Diagnosis Statement:
Acute Pain related to inflammatory process of gonorrheal infection as evidenced by reports of dysuria, abdominal pain, and/or painful intercourse.

Related Factors:

  • Inflammatory response
  • Tissue inflammation
  • Urethral irritation
  • Cervical/urethral discharge

Nursing Interventions and Rationales:

  1. Assess pain characteristics
    Rationale: Establishes baseline for intervention effectiveness
  2. Administer prescribed pain medications
    Rationale: Reduces discomfort and promotes comfort
  3. Teach comfort measures
    Rationale: Provides non-pharmacological pain management options

Desired Outcomes:

  • The patient will report decreased pain levels
  • The patient will demonstrate the use of comfort measures
  • The patient will maintain comfort during the treatment

Nursing Care Plan 4: Anxiety

Nursing Diagnosis Statement:
Anxiety related to STI diagnosis and implications for relationships as evidenced by expressed concerns and fear of partner reaction.

Related Factors:

  • Stigma associated with STIs
  • Relationship concerns
  • Fear of future complications
  • Uncertainty about treatment outcome

Nursing Interventions and Rationales:

  1. Provide emotional support
    Rationale: Reduces anxiety and promotes coping
  2. Refer to counseling services
    Rationale: Offers professional emotional support
  3. Discuss coping strategies
    Rationale: Enhances ability to manage stress

Desired Outcomes:

  • The patient will demonstrate reduced anxiety levels
  • The patient will utilize effective coping strategies
  • The patient will express feelings appropriately

Nursing Care Plan 5: Risk for Impaired Reproductive Function

Nursing Diagnosis Statement:
Risk for Impaired Reproductive Function related to untreated gonorrheal infection as evidenced by potential for PID or epididymitis.

Related Factors:

  • Bacterial infection
  • Delayed treatment
  • Anatomical changes
  • Inflammatory response

Nursing Interventions and Rationales:

  1. Monitor for complications
    Rationale: Enables early intervention
  2. Educate about fertility implications
    Rationale: Promotes understanding of long-term effects
  3. Ensure timely treatment
    Rationale: Prevents reproductive complications

Desired Outcomes:

  • The patient will complete treatment before complications develop
  • The patient will understand the importance of follow-up care
  • The patient will recognize warning signs requiring medical attention

References

  1. Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2023). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier. 
  2. Harding, M. M., Kwong, J., & Hagler, D. (2022). Lewis’s Medical-Surgical Nursing: Assessment and Management of Clinical Problems, Single Volume. Elsevier.
  3. Herdman, T. H., Kamitsuru, S., & Lopes, C. (2024). NANDA International Nursing Diagnoses – Definitions and Classification, 2024-2026.
  4. Ignatavicius, D. D., Rebar, C., & Heimgartner, N. M. (2023). Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care. Elsevier.
  5. Laughon K, Sutherland MA, Parker BJ. A brief intervention for prevention of sexually transmitted infection among battered women. J Obstet Gynecol Neonatal Nurs. 2011 Nov-Dec;40(6):702-8. doi: 10.1111/j.1552-6909.2011.01305.x. PMID: 22273449; PMCID: PMC6996018.
  6. Marrazzo JM, Cates W. Interventions to prevent sexually transmitted infections, including HIV infection. Clin Infect Dis. 2011 Dec;53 Suppl 3(Suppl 3):S64-78. doi: 10.1093/cid/cir695. PMID: 22080271; PMCID: PMC3213401.
  7. Silvestri, L. A. (2023). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier. 
  8. Wi T, Lahra MM, Ndowa F, Bala M, Dillon JR, Ramon-Pardo P, Eremin SR, Bolan G, Unemo M. Antimicrobial resistance in Neisseria gonorrhoeae: Global surveillance and a call for international collaborative action. PLoS Med. 2017 Jul 7;14(7):e1002344. doi: 10.1371/journal.pmed.1002344. PMID: 28686231; PMCID: PMC5501266.
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Anna Curran. RN, BSN, PHN

Anna Curran. RN, BSN, PHN I am a Critical Care ER nurse. I have been in this field for over 30 years. I also began teaching BSN and LVN students and found that by writing additional study guides helped their knowledge base, especially when it was time to take the NCLEX examinations.
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