A male client is diagnosed with gonorrhea. When teaching the client about this disease, the nurse should include which instruction?
A. “Avoid sexual intercourse until you’ve completed treatment, which takes 14 to 21 days.”
B. “Wash your hands thoroughly to avoid transferring the infection to your eyes.”
C. “If you have intercourse before treatment ends, tell sexual partners of your status and have them wash well after intercourse.”
D. “If you don’t get treatment, you may develop meningitis and suffer widespread central nervous system (CNS) damage.”
Correct Answer: B. “Wash your hands thoroughly to avoid transferring the infection to your eyes.”
Adults and children with gonorrhea may develop gonococcal conjunctivitis by touching the eyes with contaminated hands. In populations other than neonates, transmission can occur via direct sexual contact with infective secretions or indirectly, for example via manual or fomite transmission, though this is thought to be less likely since N. gonorrhea does not typically survive more than a few minutes outside the human body.
Option A: The client should avoid sexual intercourse until treatment is completed, which usually takes 4 to 7 days, and a follow-up culture confirms that the infection has been eradicated. Untreated cases can result in severe complications such as vision loss if the bacteria penetrate further and cause corneal ulceration and scarring. Timely ophthalmology consultation is warranted due to the significant risks to the patient’s vision.
Option C: A client who doesn’t refrain from intercourse before treatment is completed should use a condom in addition to informing sex partners of the client’s health status and instructing them to wash well after intercourse. Furthermore, attention should be given to appropriate treatment since fluoroquinolone resistance has become a growing issue, which is part of the reason why cephalosporins have become the mainstay of gonococcal treatment.
Option D: Meningitis and widespread CNS damage are potential complications of untreated syphilis, not gonorrhea. The main concept is that N. gonorrhoeae can attach to and penetrate the epithelial cells of mucosal surfaces such as the conjunctiva. Once inside, the bacteria can proliferate and induce pro-inflammatory mechanisms. However, there is evidence that N. gonorrhoeae have developed methods for evading and even modulating immune responses, which can potentially lead to disseminated infection, for example, bacteremia or meningitis.
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