A woman hoping to conceive, composite and newly diagnosed with stage 2 hypertension, gets a numeric target, a drug chosen with pregnancy in mind and a dated recheck in NU568's plan. Searches like "nu 568 unit 3 assignment example", "nu568 unit 3 sample" and "nu568 unit 3 example" land here.
Hypertension at 37 With a Pregnancy Planned Within Two Years: A Management Plan That Excludes Two First-Line Classes
[Student Name]
Purdue University Global
NU568: FNP I - Primary Care Across the Lifespan
Unit 3 Hypertension Management Plan
[Instructor Name]
[Date]
The patient is a composite; readings, results and agents in brackets are illustrative.
Assessment
Ms. [T.], 37, has had office readings of [146/90] and [142/88] at two visits and a home average of 144/88 mm Hg over 14 days, confirming stage 2 hypertension by the 2017 ACC/AHA classification, which places any average at or above 140 systolic, or at or above 90 diastolic, in stage 2 (Whelton et al., 2018). Workup: basic metabolic panel, lipids, A1C, TSH, urinalysis and ECG, all [unremarkable]. BMI [29]. She does not smoke, drinks [two] glasses of wine a week and takes no medicines. Her 10-year cardiovascular risk is low, but her lifetime risk is not, and stage 2 readings call for drug treatment with lifestyle change.
Part 1: Target
Below [130/80] mm Hg, on home and office readings (Whelton et al., 2018).
Part 2: Lifestyle, Counted
1. Sodium: below [1,500] mg a day; she will read labels on her three usual lunch items this week.
2. Potassium-rich foods: two extra servings of fruit or vegetables a day.
3. Activity: 150 minutes a week of brisk walking, as three 50-minute walks, starting with two.
4. Weight: a [5] percent loss over six months, about [4] kg.
5. Alcohol: stays at two drinks a week or fewer.
Each measure lowers systolic pressure by a few millimeters; together they may lower it by 10 or more.
Part 3: Drug Therapy, Step 1: What Is Excluded
ACE inhibitors and angiotensin receptor blockers are set aside, even though they are first-line for many adults, because they cause fetal harm and she may conceive before she thinks to stop them. Both classes carry a boxed warning for fetal toxicity: second- and third-trimester exposure disrupts the fetal renin-angiotensin system, causing kidney damage, low amniotic fluid and skull and lung underdevelopment. First-trimester exposure has also been associated with major malformations in one cohort study, although that finding has been debated (Cooper et al., 2006). Around half of pregnancies are unplanned, and many women do not know they are pregnant until several weeks in. Starting a drug she must stop before conception, when she may not know the date, builds a risk into the plan.
Thiazide diuretics, another first-line class, are not absolutely contraindicated in pregnancy, but they are not preferred there, and switching drugs before conception would add a change she can avoid.
Part 3: Drug Therapy, Step 2: What Fits
[Extended-release nifedipine], [30] mg daily. A dihydropyridine calcium channel blocker is first-line for adults, lowers pressure effectively once daily, and is one of the agents ACOG recommends for chronic hypertension in pregnancy (American College of Obstetricians and Gynecologists [ACOG], 2019). If she conceives, she can stay on the same drug. Expected adverse effects: ankle swelling, flushing, headache.
Alternative: [labetalol], also recommended in pregnancy (ACOG, 2019), taken twice daily, with fatigue and, in people with asthma, bronchospasm as concerns. The choice between them is hers after hearing both.
Treating chronic hypertension in pregnancy to a target below 140/90 mm Hg reduced adverse pregnancy outcomes in a large trial, which supports keeping her on treatment through a pregnancy rather than stopping (Tita et al., 2022).
Why Start a Drug Now, Two Years Before a Pregnancy
She asked whether she could wait and try lifestyle changes alone until after a pregnancy. For stage 2 readings, the guideline recommends drug therapy alongside lifestyle change rather than lifestyle alone, because pressures at this level carry risk to the heart, kidneys and brain over time (Whelton et al., 2018). Pregnancy adds a second reason. Chronic hypertension raises the risk of preeclampsia, fetal growth restriction and preterm birth, and entering pregnancy with controlled pressure on a drug that can continue is safer than entering it untreated or on a drug that must be stopped. Starting now also gives two years to find the dose and agent that suit her, so that the preconception visit is a review rather than a change. If lifestyle measures bring her home average below target for three months, a trial of a lower dose would be reasonable, with home monitoring.
Part 4: Contraception and Preconception Counseling
Recorded as part of the plan: she uses [condoms]; a more effective method until she is ready to conceive was discussed. She will tell us when she plans to stop contraception, so that we can review her pressure, her medicine and folic acid beforehand. If she becomes pregnant unexpectedly, she keeps taking nifedipine and calls.
Part 5: Secondary Causes and Referral
At 37 with a gradual onset, normal potassium and no features of a secondary cause, a wider search is not indicated now. Resistant hypertension, low potassium, a sudden rise, or symptoms such as episodic headache with palpitations and sweating would prompt testing for primary aldosteronism, renal artery disease or pheochromocytoma.
Part 6: Follow-Up
Recheck in [30] days, on [date], with home readings twice daily for the week before. If the average is at or above 130/80, increase nifedipine to [60] mg or add [labetalol]. Once at target, every [three to six] months, and at the preconception visit.
References
American College of Obstetricians and Gynecologists. (2019). ACOG Practice Bulletin No. 203: Chronic hypertension in pregnancy. Obstetrics & Gynecology, 133(1), e26-e50. https://doi.org/10.1097/AOG.0000000000003020
Cooper, W. O., Hernandez-Diaz, S., Arbogast, P. G., Dudley, J. A., Dyer, S., Gideon, P. S., Hall, K., & Ray, W. A. (2006). Major congenital malformations after first-trimester exposure to ACE inhibitors. New England Journal of Medicine, 354(23), 2443-2451. https://doi.org/10.1056/NEJMoa055202
Tita, A. T., Szychowski, J. M., Boggess, K., Dugoff, L., Sibai, B., Lawrence, K., Hughes, B. L., Bell, J., Aagaard, K., Edwards, R. K., Gibson, K., Haas, D. M., Plante, L., Metz, T., Casey, B., Esplin, S., Longo, S., Hoffman, M., Saade, G. R., ... Andrews, W. W. (2022). Treatment for mild chronic hypertension during pregnancy. New England Journal of Medicine, 386(19), 1781-1792. https://doi.org/10.1056/NEJMoa2201295
Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Collins, K. J., Dennison Himmelfarb, C., DePalma, S. M., Gidding, S., Jamerson, K. A., Jones, D. W., MacLaughlin, E. J., Muntner, P., Ovbiagele, B., Smith, S. C., Spencer, C. C., Stafford, R. S., Taler, S. J., Thomas, R. J., Williams, K. A., ... Wright, J. T. (2018). 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: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension, 71(6), e13-e115. https://doi.org/10.1161/HYP.0000000000000065
How this NU568 Unit 3 example is structured
The plan follows the order most rubrics expect for a new chronic diagnosis, assessment then target then therapy then follow-up, and each part cites its source by year. Staging and target come from the adult guideline, cited as the 2017 ACC/AHA document with a note that its 2025 AHA/ACC successor kept the same categories. Drug selection is argued in two steps: which classes are excluded for this patient and why, then which remaining class fits. The exclusion step is the plan's graded center, because a reader applying a generic first-line list would prescribe an agent she should avoid. Referral thresholds and secondary causes get a short paragraph, noting why her age and presentation do not prompt a wider search. The follow-up line carries a date and a condition, including the step to take if the target is not met at that visit.
Get an NU568 Unit 3 example written to your instructions
Every Unit 3 case sets its own patient, so paste yours as your NU568 instructor released it, readings, history and any stated plans included, along with the rubric. The model plan states a numeric target, argues its drug choice from that patient's details and dates the recheck. It arrives in 24-48h; a first request is free. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
NU568 Unit 3 questions, answered
Which hypertension guideline should the plan cite?
Whichever your section names. If none is specified, the 2025 AHA/ACC adult guideline is the most recent from those bodies, and it kept the stage categories introduced in 2017. Many courses still cite the 2017 document, which is acceptable if the rubric allows it. Name the edition applied and avoid mixing thresholds from different years in one plan.
Does the plan need a secondary hypertension workup?
A short paragraph is usually enough for a patient like this one: basic laboratory tests, and a sentence explaining why her age, severity and history do not call for a wider search. If the case includes clues such as low potassium, resistant readings or very early onset, the plan should say which secondary cause each clue raises and what it would prompt.
How specific should lifestyle recommendations be?
Specific enough to measure at the next visit. A sodium target, minutes of activity, a drink limit and a weight goal, each with a number in brackets, give the follow-up something to check. General encouragement to eat well and exercise reads as filler, and graders often note when a plan attaches no expected effect to any change it proposes.