Question

The physician has ordered a culture for the client with suspected gonorrhea. The nurse should obtain which type of culture? A. Blood B. Nasopharyngeal secretions C. Stool D. Genital secretions

Short answer

Answer: D. Genital secretions.

Step-by-step solution

Understanding gonorrhea

Gonorrhea is a sexually transmitted infection caused by the bacteria Neisseria gonorrhoeae. It mainly affects the genitals, rectum, and throat. It's essential to know the common site of infection to determine which culture is appropriate for diagnosis.

Evaluating the given options

We have four options to choose from: A. Blood B. Nasopharyngeal secretions C. Stool D. Genital secretions Let's evaluate each option:

Option A: Blood

Though gonorrhea can infect the bloodstream, it's relatively rare. Blood cultures are not the primary choice for diagnosing gonorrhea.

Option B: Nasopharyngeal secretions

Gonorrhea can infect the pharynx, and nasopharyngeal secretions could potentially show the presence of Neisseria gonorrhoeae. However, this is a less common site for infection and not the optimal choice for screening.

Option C: Stool

Gonorrhea can infect the rectum, but stool samples are not commonly used for diagnosing gonorrhea, as the bacteria might not be present in sufficient quantities for detection.

Option D: Genital secretions

Gonorrhea mainly infects the genital area, and genital secretions are the most common and reliable choice for diagnosing gonorrhea. A swab from the infected area (cervix, urethra, or rectum) is typically used to obtain a sample for testing.

Choose the correct answer

Based on the analysis, the optimal culture to obtain for a client with suspected gonorrhea is the one from the most common site of infection, which is genital secretions. Therefore, the correct answer is D. Genital secretions.

Key concepts

Understanding Sexually Transmitted Infections

Sexually Transmitted Infections (STIs), also known as sexually transmitted diseases (STDs), are infections that are most commonly spread through sexual contact, including vaginal, anal, and oral intercourse. These infections can be caused by a variety of microorganisms, such as bacteria, viruses, and parasites.

Some common STIs include chlamydia, herpes, HIV/AIDS, human papillomavirus (HPV), syphilis, and gonorrhea. Symptoms can vary widely, from mild or even unnoticed to severe, and they can lead to long-term health problems if left untreated. Regular screening and early diagnosis are crucial in effectively managing and preventing the spread of STIs.

Many STIs, including gonorrhea, can be cured with appropriate treatment, typically involving antimicrobials or antibiotics. It's important for sexually active individuals to engage in safe sex practices, such as condom use, and undergo regular testing to safeguard their health and that of their partners.

The Bacterium Neisseria gonorrhoeae

Neisseria gonorrhoeae is the bacterial pathogen responsible for gonorrhea, which is one of the oldest known sexually transmitted infections. This bacterium specifically targets the mucous membranes of the body, including those covering the internal reproductive organs, mouth, throat, and anus.

The infection causes a range of symptoms, which for genital infections may include a burning sensation during urination, discharge, and in women, possible pelvic inflammatory disease if untreated. Gonococcal infections of the throat or rectum may cause localized redness, discomfort, and discharge, or they may be asymptomatic. Identifying the presence of Neisseria gonorrhoeae is essential for proper treatment to be administered, as antibiotic resistance in this organism has been increasing, highlighting the importance of accurate diagnosis and prescription of effective antibiotics.

Culture Collection Methods for Gonorrhea

When diagnosing gonorrhea, healthcare providers have various culture collection methods at their disposal. The goal is to gather a sample from the site where Neisseria gonorrhoeae is most likely to be present if the infection exists. Here are some standard methods:

Genital Swab

A specimen is taken from the cervix, urethra, or rectum using a sterile swab. This is the most common method of testing for gonorrhea in sexually active adults.

Urine Test

First-catch urine (the first part of the urine stream) is collected to test for the presence of the bacteria's genetic material, an approach known as nucleic acid amplification testing (NAAT).

Throat or Oral Swab

A swab is used to collect a sample from the throat if oral sex is a possible route of transmission. Although less common, this method is becoming more essential in comprehensive STI screening.

For the most accurate diagnosis of gonorrhea, the selection of the culture site gets based on the individual's reported sexual practices and symptoms. The genital swab remains the primary choice for routine gonorrhea screening.