Nursing Guide to Gonorrhea: Nursing Diagnosis, Interventions, & Care Plans

Gonorrhea Definition 

Gonorrhea is a common sexually transmitted infection (STI). It primarily affects the genitals, rectum, and throat of both males and females. It can affect other areas of the body, including the throat, eyes, and joints. In females, the cervix can also be affected. During childbirth, gonorrhea can be transmitted to the infant. While often asymptomatic, untreated gonorrhea can result in severe complications, including infertility and systemic infections (Cleveland Clinic, 2024).   

Etiology of Gonorrhea

Gonorrhea is caused by the bacterium Neisseria gonorrhea, which infects mucous membranes. It is transmitted through unprotected vaginal, anal, and oral sex. Global prevalence remains high, with 82.4 million new cases estimated in 2020, predominantly among individuals aged 15 to 24 and high-risk populations (World Health Organization, 2024). 

Risk factors include: 

• Multiple sexual partners
• Inconsistent condom use
• Previous STI 

Diagnostic Criteria 

Diagnostic tests include (World Health Organization, 2024): 

• Gram stain microscopy for male urethral discharge or culture, which is used in resource-limited settings.
• Nucleic acid amplification testing (NAAT) and point of care (POC) NAAT, which are the gold standards. Urine and endocervical, vaginal, urethral, rectal, and pharyngeal swab specimens are used for testing. 

In settings without diagnostic capacity, individuals with symptoms such as urethral discharge or cervicitis are treated presumptively. 

Common Signs and Symptoms 

Symptoms in women include: 

• Increased vaginal discharge
• Dysuria
• Intermenstrual bleeding
• Painful intercourse
• Abdominal pain 

Symptoms in men include: 

• White, yellow, or green discharge from the penis
• Testicular pain
• Dysuria 

Rectal infection symptoms include: 

• Painful bowel movements
• Rectal bleeding
• Rectal discharge and itching 

Throat infection symptoms include:  

• Sore throat
• Scratchiness
• Difficulty swallowing 

Red Flags 

Severe lower abdominal pain may indicate pelvic inflammatory disease, which causes scarring of the fallopian tube and may result in ectopic pregnancy or infertility. 

Vision changes or eye discharge in newborns. Gonococcal conjunctivitis in newborns can lead to corneal ulceration and blindness. 

Disseminated gonococcal infection (DGI) is a sepsis-like illness with skin lesions, arthritis, endocarditis, and meningitis. Symptoms include fever, skin lesions, and joint pain. 

Potential Complications with Gonorrhea

Often, gonorrhea has no symptoms, but it can cause serious complications even without symptoms (Centers for Disease Control and Prevention [CDC], 2024). 

Some of the complications include: 

• Painful joints
• Liver inflammation
• Heart valve damage
• Brain damage
• Pelvic inflammatory disease in women
• Ectopic pregnancy
• Infertility
• Epididymitis in men
• Urethral stricture in men 

Gonorrhea-induced inflammation raises HIV transmission risk. 

Treatment for Gonorrhea

Treatment for gonorrhea is limited to pharmacological options. 

Pharmacological 

Gonorrhea may be managed with antibiotic therapy, if appropriate. Uncomplicated cases of gonorrhea can be treated with a recommended one-dose injection of ceftriaxone (Rocephin®), with dosage based on weight (Clevland Clinic, 2024). 

When ceftriaxone is unavailable, gentamicin (Garamycin®) is given as an injection in a single dose, and azithromycin (Zithromax®) is given orally in a single dose. 

Retesting should occur after 3 months to confirm clearance and prevent reinfection. 

Gonorrhea Nursing Management Care Plan

Assessment and Interventions 

To assess infection risk:   

• Obtain a history of sexual practices, STI history, and current symptoms.
• Check for discharge, redness, and swelling in affected areas.
• Evaluate for depression, anxiety, or stigma-related distress.
• Administer prescribed antibiotics and monitor for adverse effects.
• Ensure all partners are treated to prevent reinfection.
• Monitor for symptoms post-treatment. 

Psychosocial and Cultural Considerations 

Psychosocial Support 

Provide psychosocial support by:   

• Offering nonjudgmental support to reduce anxiety or shame associated with STI diagnosis.
• Recommending counseling or support groups, if needed.
• Offering scripted examples for discussing STI status with partners. 

Cultural Considerations 

To provide culturally sensitive care: 

• Address cultural barriers to condom use and STI screening.
• Support safe partner disclosure practices in cases of stigma or risk. 

Home Management 

Self-Care 

Management of self-care includes: 

• Completing all antibiotics and avoiding sex for 7 days post-treatment (CDC, 2024).
• Following up with retesting in 3 months. 

Safety Measures 

Provide the following safety measures: 

• Encourage consistent condom use.
• Educate on reinfection risks, even if asymptomatic.
• Provide resources for partner screening. 

Content Release Date

4/1/2022

Content Expiration

12/31/2028

Course Contributor 

The content for this course was revised by Kim Matthews, RN. Ms. Matthews obtained a nursing degree from Western Kentucky University in 1998. Ms. Matthews possesses over 20 years of nursing experience, with over 17 of those in the Skilled Nursing industry. Ms. Matthews has extensive experience in MDS, restorative nursing programs, and nursing management. Ms. Matthews is currently a Post-Acute Care Content writer and subject matter expert for MDS.

References 

• Centers for Disease Control and Prevention. (2025). About gonorrhea. https://www.cdc.gov/gonorrhea/about/index.html
• Cleveland Clinic. (2024). Gonorrhea. https://my.clevelandclinic.org/health/diseases/4217-gonorrhea  
• World Health Organization. (2024). Gonorrhea: Neisseria gonorrhoeae infection. https://www.who.int/news-room/fact-sheets/detail/gonorrhoea-(neisseria-gonorrhoeae-infection)