Video summary

Gonorrhea Symptoms, Treatment, STI Nursing NCLEX Review

Main summary

Key takeaways

Educational

Main ideas / concepts covered

Gonorrhea overview

  • Gonorrhea is caused by Neisseria gonorrhoeae (noted in the video as “neria gori” / similar auto-caption errors).
  • It is Gram-negative.
  • On Gram stain, it appears as round bacteria in pairs → diplococci.

Transmission

Gonorrhea spreads through:

  • Sexual transmission via unprotected contact, involving:
    • Genitals
    • Mouth
    • Anus
  • Perinatal transmission:
    • During birth/delivery, the baby may contact bacteria in the birth canal.

Potential newborn complications include:

  • Premature birth
  • Eye infection (conjunctivitis), which can lead to blindness
  • Meningitis

Signs & symptoms (memory aid: “CLAP”)

  • C = Conjunctivitis
    • Primarily in newborns exposed during delivery.
  • L = Tender testicles
    • In males: very swollen, painful testicles
    • Untreated infection can lead to infertility
  • A = Dysuria
    • Burning sensation when urinating
  • P = “Whatever organ/area was infected”
    • Symptoms depend on site: genitals, throat, or anus

Additional points noted:

  • Women-specific note: Women may present with vaginal infection/UTI-like symptoms and may not show all the classic features.
  • Abnormal discharge:
    • Thick, greenish/yellow
    • Occurs in the affected area (penis/vagina/anus)

Complications (especially if untreated)

  • Pelvic inflammatory disease (PID)
    • Can spread to fallopian tubes, ovaries, and uterus
    • May lead to:
      • Abdominal/pelvic pain
      • Infertility
      • Ectopic pregnancies

Nurse role and clinical priorities (methodology / steps)

Assessment / identification

  • Identify patients with signs and symptoms consistent with gonorrhea (use CLAP as the cue).
  • Prioritize assessment for high-risk groups, including:
    • Age 25 or younger and sexually active
    • Multiple sex partners
    • No protection/barrier use
    • Incarcerated individuals
    • Patients with a positive STI test (co-infection is common)

Testing

  • Test at-risk and symptomatic patients for gonorrhea.
  • Common practice: test gonorrhea and chlamydia together, as they often co-occur.
  • Specimen types mentioned:
    • Urine sample
    • Swab from the affected site

Screening guidance (CDC referenced)

  • Non-pregnant, sexually active <25 years: yearly testing
  • Pregnancy:
    • Test at the first prenatal visit (including those <25)
    • If older: test at the first prenatal visit if high risk
    • Re-test during third trimester (~28 weeks)

Treatment

  • Since it is Gram-negative, treatment is antibiotic therapy.

Non-pregnant, uncomplicated gonorrhea

  • Single dose ceftriaxone IM
  • If chlamydia has not been excluded, add doxycycline

Pregnant patients

  • Use the same core approach, with an important exception:
    • If chlamydia has not been excluded, use an alternative regimen because doxycycline is contraindicated in pregnancy (risk to bone/tooth development).

The video notes that older CDC dual therapy (ceftriaxone + azithromycin) is no longer the current approach.

Patient education / counseling

  • No sexual activity for 7 days after:
    • taking all medications, and
    • being free of signs/symptoms
  • When resuming sex:
    • Use a barrier method to prevent reinfection
  • Partner management:
    • Ensure partner(s) get tested and treated to prevent reinfection
  • Retesting/follow-up:
    • In 3 months, both non-pregnant and pregnant patients should be re-tested to confirm cure or identify reinfection

Sources / speakers

  • Nurse Sarah (speaker/host of the video)
  • CDC (Centers for Disease Control and Prevention) (referenced for screening and treatment recommendations)

Original video