NCLEX Review Guide: Prostatitis

Understanding Prostatitis

• Prostatitis is inflammation of the prostate gland, affecting men of all ages but most common in men 30-50 years old
• Acute bacterial prostatitis is a sudden onset infection requiring immediate antibiotic treatment
• Chronic bacterial prostatitis involves recurrent UTIs with same bacterial organism over months
• Chronic pelvic pain syndrome (nonbacterial) is most common type with unclear etiology

Signs & Symptoms

• Acute prostatitis: High fever, chills, severe pelvic/perineal pain, dysuria, urinary frequency/urgency
• Chronic prostatitis: Intermittent pelvic discomfort, mild dysuria, post-ejaculatory pain, lower back pain
• Obstructive symptoms: Hesitancy, weak stream, incomplete bladder emptying, nocturia
• Physical exam reveals tender, swollen, warm prostate on digital rectal examination

Key Diagnostics

• Urinalysis and urine culture show WBCs, bacteria, and positive culture in bacterial types
• Prostate-specific antigen (PSA) may be elevated but avoid vigorous prostate massage in acute cases
• Complete blood count shows elevated WBC count in acute bacterial prostatitis
• Transrectal ultrasound may identify complications like abscess formation

Medical Management

1. Antibiotic therapy: Fluoroquinolones (ciprofloxacin) or trimethoprim-sulfamethoxazole for 4-6 weeks
2. Alpha-blockers (tamsulosin) to improve urinary flow and reduce obstruction
3. Anti-inflammatory medications and analgesics for pain management
4. Stool softeners to prevent straining during defecation

Nursing Interventions

• Monitor for acute urinary retention - may require catheterization
• Encourage increased fluid intake (2-3 L/day) unless contraindicated
• Provide comfort measures: sitz baths, heat application to perineum
• Educate about medication compliance - complete full antibiotic course

Teaching Points

• Practice safe sex and maintain good hygiene to prevent bacterial infections
• Avoid activities that increase pelvic pressure: prolonged sitting, bicycle riding during acute phase
• Regular ejaculation may help prevent chronic prostatitis by clearing prostatic secretions
• Avoid alcohol, caffeine, and spicy foods that may irritate the bladder

Knowledge Check

• ☐ Can identify difference between acute and chronic prostatitis symptoms
• ☐ Knows appropriate antibiotic duration for bacterial prostatitis
• ☐ Understands when to avoid prostate massage
• ☐ Can list priority nursing interventions for acute prostatitis
• ☐ Remembers key patient teaching points for prevention