NSG 6005 Week 3 DQ 1: hypertension in CF's case
For CF, a 60-year-old African American man with twelve years of hypertension and type 2 diabetes on Maxzide alone at 162/90, discuss how age, gender and ethnicity influence antihypertensive choice, then give one option for improvement with dosage, scheduling, justification and patient teaching.
Editorial process
Last reviewed · August 14, 2026
Three demographic factors, and one comorbidity that outranks them
Answer the demographic question the prompt actually asks, then let the comorbidity settle it. Ethnicity first, because it carries the most specific prescribing guidance: guidelines recommend a thiazide-type diuretic or a calcium channel blocker as initial therapy for Black adults without chronic kidney disease, since single-agent renin-angiotensin blockade is on average less effective in this group, and angio-oedema with ACE inhibitors is more frequent. Age next: at sixty, isolated systolic elevation and arterial stiffness dominate, comorbidity is common, and the trade-off between intensive control and orthostatic hypotension becomes real. Gender is the weakest of the three for drug selection and it is honest to say so, while noting adherence and adverse-effect patterns that differ. Then note what the vignette is really doing: CF has type 2 diabetes, and diabetes with albuminuria makes an ACE inhibitor or ARB compelling despite the ethnicity guidance, so the interesting answer depends on a urine albumin-to-creatinine ratio you should say you would obtain.
Now make one specific change, because the prompt asks for one option with dosage and scheduling. CF is on Maxzide alone — triamterene 37.5 mg with hydrochlorothiazide 25 mg — and is 162/90, well above the target for a patient with diabetes, so monotherapy has failed and guidelines support starting two agents when systolic pressure is more than 20 mmHg above target. The defensible choice is to add amlodipine 5 mg once daily, titrating to 10 mg after two to four weeks, which pairs with a thiazide for this population and has strong outcome evidence in combination; if the albumin-to-creatinine ratio is raised, add lisinopril instead, starting at 10 mg daily. Give the monitoring: repeat pressure in two to four weeks, basic metabolic panel for potassium and creatinine, and ankle oedema. Then teach concretely — home monitoring technique, sodium under 1,500 mg, DASH, weight loss from a BMI of 32, alcohol, activity, and why he must not stop when he feels well.
Likely learning objectives
Inferred from the brief — check these against your own rubric.
- 01Apply demographic prescribing guidance to a specific hypertensive patient.
- 02Recognise when a comorbidity overrides the demographic default.
- 03Specify a medication change with dose, schedule and monitoring.
- 04Deliver lifestyle and adherence teaching matched to the patient.
Read the full question
Review every instruction before using the planning guidance that follows.
Course-wide instructions that accompany this question
ADDITIONAL INSTRUCTIONS FOR THE CLASS Discussion Questions (DQ) Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. NSG 6005 Week 3 Assignment 1 DQ 1 One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses. Weekly Participation Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week. APA Format and Writing Quality Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition. Use of Direct Quotes I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source. LopesWrite Policy For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score. Late Policy The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading. Communication Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.
Turn the brief into deliverables
- 01The influence of age on antihypertensive medication choice.
- 02The influence of gender.
- 03The influence of ethnicity.
- 04One option for improving his blood pressure, with dosage and scheduling.
- 05A clear and specific justification for that choice.
- 06Patient teaching and lifestyle recommendations, with a guideline and a peer-reviewed source.
The factors, the change, the teaching
Where CF is now
Twelve years of hypertension, diabetes, BMI 32, 162/90 on monotherapy.
Ethnicity and drug class
Thiazide or calcium channel blocker first-line, and why.
Age and gender
Arterial stiffness and orthostasis; adherence and adverse-effect patterns.
The comorbidity that decides it
Diabetes, albuminuria, the target, and the test you would order.
The change, precisely
Agent, starting dose, schedule, titration, and combination rationale.
Monitoring and teaching
Follow-up interval, labs, home monitoring, sodium, weight, adherence.
One guideline and one peer-reviewed source, as required
Recommended databases
- ACC/AHA hypertension guideline
- StatPearls, NCBI Bookshelf
- NHLBI
- South University Online Library
Search sequence
- 1.Open the current hypertension guideline and find the initial-therapy recommendation for Black adults.
- 2.Find the blood pressure target for a patient with diabetes.
- 3.Check when two-drug initial therapy is recommended.
- 4.Confirm the starting dose and titration interval for your chosen agent.
- 5.Note the DASH sodium target you intend to teach.
Reference shortlist
These are authoritative starting points, not a ready-made bibliography. A qualified reviewer must confirm that each source fits the assignment and supports the claim beside which it is cited.
Nothing here is cleared for citation until you have read it.
- 01
2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults
Hypertension, American Heart Association · 2018
The clinical guideline the prompt requires, including initial therapy by race and comorbidity.
- 02
Essential Hypertension
StatPearls, NCBI Bookshelf · 2023
Pathophysiology, drug classes and the rationale for combination therapy.
- 03
The DASH Diet: A Guide to Managing Hypertension Through Nutrition
StatPearls, NCBI Bookshelf · 2024
The dietary intervention and sodium target for the teaching section.
- 04
High Blood Pressure - What Is High Blood Pressure? | NHLBI, NIH
National Heart, Lung, and Blood Institute · 2025
Patient-facing material for home monitoring and adherence teaching.
Review before submission
Common mistakes
- Increasing the existing thiazide rather than adding a second agent.
- Ignoring the diabetes, which changes both the target and the class.
- Recommending an ACE inhibitor on ethnicity grounds without checking albuminuria.
- Giving a drug name with no dose, no schedule and no titration.
- Omitting the metabolic panel after starting or changing therapy.
- Offering generic lifestyle advice with no numbers.
Submission checklist
- All three demographic factors are addressed separately.
- The diabetes is used to set the blood pressure target.
- One change is named with dose, frequency and titration.
- Monitoring and follow-up interval are specified.
- Teaching includes sodium, weight, activity and adherence.
- One clinical guideline and one peer-reviewed publication are cited.
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Aaron Bishop
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