Name of the student :

Name of the evaluator:

Class : 1st yr M.Sc Nursing
Subject : child health nursing
Unit : Unit V
Placement : I B.Sc Nursing Students
No. of students : 50 students
Venue : I year B.Sc Nursing classroom
Date :
Time : 2-4pm
AV Aids : Blackboard, Chart, OHP.
Method of teaching : Lecture cum discussion
GENERAL OBJECTIVES : At the end of the class, the students will acquire adequate knowledge regarding AIDS and its
management in clinical area.
Specific objectives : At the end of the class, students will be able to;

1. define AIDS.
2. list out the etiology and risk factors OF AIDS.
3. describe the pathophysiology
4. explain the clinical features.
5. details of diagnostic evaluation.
6. list out the complications.
7. explain the treatment regimen- medical, surgical managements.
8. discuss the nursing management of patient with aids.
9. discuss the preventive measures.
SL. TIME SPECIFIC CONTENTS AV TEACHERS STUDENTS EVALUATION
OBJECTIVES AIDS ACTIVITY ACTIVITY

ACQUIRED IMMUNO DEFICIENCY SYNDROME

1. 1minutes To introduce INTRODUCTION Black The teacher Students

the lesson for The human immunodeficiency virus (HIV) board introduces the will listen
the day topic
was unknown until the early 1980's but since
that time has infected millions of persons in a
worldwide pandemic. The result of HIV infection
is relentless destruction of the immune system
leading to onset of the acquired
immunodeficiency syndrome (AIDS). The AIDS
epidemic has already resulted in the deaths of
over half its victims. All HIV-infected persons are
at risk for illness and death from opportunistic
infectious and neoplastic complications as a
consequence of the inevitable manifestations of
AIDS.

2. 2minutes -To define -DEFINITION OF THE AIDS. OHP -Teacher -Students Define AIDS?
AIDS. defines AIDS will listen
Acquired immune deficiency syndrome and copies it
(AIDS) is an infectious disease caused by the
human immunodeficiency virus (HIV). It
manifests itself only after a long latency period
after initial HIV infection. AIDS is a fatal disease
for which there is currently no cure.

3. 2minutes -To list out the -ETIOLOGY AND RISK FACTORS OHP -Teacher lists -Students List the
 etiology and AIDS is caused by the Human Immunodeficiency and explains listens and etiology for
Risk factors Virus. the etiology and make a note AIDS?
risk factors of it
HIV/AIDS can be transmitted in several
ways. The various routes of transmission
include:
 Sexual contact.
- Unprotected sex
- Anal inter-course,
- Sex with HIV infected partner
- Heterogamous

 Mother to Neonate/newborn.
- During birth
- Breast feeding
- Vaginal delivery doubles the risk of
transmitting HIV to the child.
 Exposure to contaminated blood or blood
products.
 Exposure of health care professionals to
infected blood.
Needle injuries.
 HIV is not transmitted by handshakes,
coughing, sneezing, or other casual non-
sexual contact. There is currently no evidence
that HIV can be transmitted through
bloodsucking insects such as mosquitoes.

4. 2minutes -To describe the Chart -Teacher Students Explain the

 pathophysiology describes the copies it pathophysiolo
pathophysiology down gy of AIDS?
PATHOPHYSIOLOGY
Due to etiological factors

Virus enters the blood

Virus binds to the protein called CD4 which

present on the surface of WBC.

Virus replicate within the cell and kill the cell

Development of auto-antibodies

Damage to the immune response

Lack of immunity against infections

Occurrence of syndrome

-To explain the

5. 3minutes clinical OHP -Teacher lists Mention the
manifestations down the Students clinical
of Wilms CLINICAL MANIFESTATIONS OF AIDS clinical listens manifestations
tumor manifestations of AIDS?
The course of AIDS generally progresses
through the three stages, such as
 Acute retroviral syndrome
- Fever
- Fatigue
- Muscle aches
 - Loss of appetite and Weight loss
- Digestive disturbances
- Skin rashes
- Chronically swollen lymph nodes.
It develops between one and six weeks
after infection and lasts for two to three weeks.
Blood tests during this period will indicate the
presence of virus.
 Latency period
During latency, the virus continues to
replicate in the lymph nodes, where it may cause
one or more of the following conditions.
 Chronic painless swellings in the lymph
nodes of the neck, jaw, groin, and armpits.
 Oral thrush, open sores or ulcers, or other
infections of the mouth;
 Diseases of the lungs and kidneys;
 Degeneration of the nerve fibers in the arms
and legs.
 General loss of strength, loss of reflexes,
 Feelings of numbness or burning sensations
in the feet or lower legs.

 Late-stage AIDS
A sharp decline in the number of CD4+
lymphocytes, followed by a rise in the frequency
of opportunistic infections and cancers.

Opportunistic Infections. Once the patient's

CD4+ lymphocyte count falls below 200
cells/mm3, the patient is at risk for a variety of
opportunistic infections.
  Pneumocystis carinii pneumonia (PCP),
 candidiasis or thrush
 cryptococcal meningitis.
 Tuberculosis
 cytomegalovirus (CMV),
 herpes simplex virus (HSV),
 varicella zoster virus (VZV),
Among children
 delayed growth,
 a history of frequent illness,
 recurrent ear infections,
 a low blood cell count,
 failure to gain weight,
 Unexplained fevers.
 bacterial infections,
 inflammation of the lungs,

-DIAGNOSTIC EVALUATION
-To explain the 1. History collection
2minutes diagnostic 2. Physical examination Black -Teacher How will you
6. evaluation 3. BLOOD TESTS (SEROLOGY). board explains the -Students diagnose the
diagnostic listen and AIDS?
Enzyme-linked immuno-sorbent assay evaluation copy it.
(ELISA) test for the presence of HIV antibody in
their blood.
Western blot or Immune-Fluorescence
Assay (IFA) for confirmation.
4. OTHER LABORATORY TESTS.
 Complete blood counts
viral load tests
p24 antigen assays
Measurements of micro globulin.
5. Diagnosis in children
Younger infants can be diagnosed by
direct culture of the HIV virus, PCR testing, and
p24 antigen testing.
Children older than 18 months is similar
to adult testing, with ELISA screening confirmed
by Western blot.

COMPLICATIONS
List out the  Kaposi's Sarcoma
2minutes complications OHP Teacher list What are all
 Mycobacterium avium complex (MAC) down the Students the
7.  Encephalitis complications listen and complications
copy it. of AIDS?
 Meningitis
 Nerve damage
 HIV encephalopathy
 AIDS dementia complex
 Behavioral changes
  Poor circulation

 Stroke

 Lymphoma

-MANAGEMENT
-to explain the OHP -Teacher
5min treatment Medical management explains the -Students List out the
regimen AIDS therapies focus on improving the treatment listen and anti-retroviral
8. regimen copy it. drugs?
quality and length of life
 AIDS-related malignancies in the central
nervous system are usually treated with
radiation therapy. Cancers elsewhere in the
body are treated with chemotherapy.
 Prophylactic Drugs
- Trimethoprim-sulfamethoxazole,
- Dapsone
- Pentamidine in aerosol form.
 ANTI-RETROVIRAL TREATMENT.
 Nucleoside reverse transcriptase inhibitors
(NRTIs). Reverse transcriptase binds to these
drugs, which in turn stop the viral replication
process.
 These drugs include
 Zidovudine
 didanosine (ddi),
 zalcitabine (ddC),
 stavudine (d4T),
  lamivudine (3TC), and
 abacavir (ABC).

 Non-nucleoside reverse transcriptase

inhibitors (NNRTIs). These drugs de-activate
the HIV enzyme reverse transcriptase.
 This class of drugs includes
 nevirapine (NVP),
 delavirdine (DLV), and
 efavirenz (EFV).
 Protease inhibitors developed resistance to
nucleoside analogues and are used in
combination with them. These compounds
include
 saquinavir (SQV),
 ritonavir (RJV),
 indinavir (IDV),
 nelfinavir (NFV), and
 amprenavir (APV).
 combinations of therapies
 abacavir, zidovudine, and lamivudine.
 Combivir, combines lamivudine and
zidovudine.
 Stimulation of blood cell production.
 Epoetin alfa (erythropoietin) may be
given to anemic patients.
 Patients with low white blood cell
counts may be given filgrastim or
 sargramostim.
 Treatment in women
anti-retroviral therapy has been shown to
reduce transmission to the infant by 65%.
Discuss the OHP Teacher discuss
5minutes nursing the nursing Students List down the
management NURSING MANAGEMENT management of actively nursing
9. AIDS patients participates diagnosis
Nutritional management in according to
 Assess Nutritional status by obtaining a discussion priority?
dietary history and identifying factors that
may interfere with oral intake,
 assess the patient’s ability to purchase and
prepare food
 Monitor Weight, anthropometric
measurements, and blood urea nitrogen
(BUN), serum protein, albumin, and
transferrin levels provide objective
measurements of nutritional status.
Maintain skin integrity
 Inspect the skin and mucous membranes are
daily for evidence of breakdown, ulceration,
or infection.
 The oral cavity is monitored for redness,
ulcerations, and the presence of creamywhite
patches indicative of candidiasis.
 Assessment of the perianal area for
excoriation and infection in patients with
profuse diarrhea is important. Wounds are
cultured to identify infectious organisms.
Assess Respiratory Status
 Monitor the patient for cough, sputum
production, shortness of breath, orthopnea,
tachypnea, and chest pain.
 The presence and quality of breath sounds
are investigated.
Assess Neurologic Status
 Neurologic status is determined by assessing
level of consciousness; orientation to person,
place, and time; and memory lapses.
 Assess Mental status
 Assess for altered gait, paralysis and seizure
activity.
Fluid And Electrolyte Balance
 Fluid and electrolyte status is assessed by
examining the skin and mucous membranes
for turgor and dryness.
 Increased thirst, decreased urine output, low
blood pressure
 The patient is assessed for signs and
symptoms of electrolyte deficits, including
decreased mental status muscle twitching,
muscle cramps, irregular pulse, nausea and
vomiting, and shallow respirations.
knowledge level
 The patient’s level of knowledge about the
disease and the modes of disease
transmission are evaluated.
 Assess level of knowledge of family and
friends.
Provide comfort to the client
Provide comfortable bed and position to
the client according to his need.
Psychological support
 Help the patient to cope with the disorder.
 Reassure the client about the treatment
 modalities.
 Further nursing management depends upon
the disease condition
Explain the Black Teacher disuses
2minutes preventive board the prevention Student How will you
measures. PREVENTION of AIDS participates prevent the
10 in AIDS?
Several types of prevention programs
discussion
have been found to be effective in reducing
sexual transmission of HIV. These include:
 targeted education for at-risk groups,
emphasizing preventive practices such as
condom use, monogamy, and HIV testing
prior to beginning a sexual relationship
 counseling with or without testing for HIV
and other sexually transmitted diseases
 education programs in institutions such as
the military, prisons, and the workplace
 greater access to condoms
Preventive measures for other modes of
transmission include:
 Making clean needles more available and
discouraging intravenous drug users from
sharing needles.
 Encouraging health care professionals to take
all necessary precautions by wearing gloves
and masks when handling body fluids.
 Encouraging health care institutions to
provide safer medical devices such as self-
sheathing needles and retracting and/or
needleless intravenous systems.
 Informing individuals who are planning to
undergo major surgery that they can donate
blood in advance to prevent a risk of infection
from a blood transfusion.
 Encouraging testing for HIV infection if there
 has been suspected exposure to HIV. If HIV
infection is confirmed, sexual partners should
be informed and, if necessary, receive
medical attention.
1minutes
Black Teacher
Summarize and AIDS is fatal disease caused by Human board summarizes the Students ask
clarifies the Immunodifficiency Virus and transmit through topic.
sexual intercourse, blood transfusion, needle doubts.
11. doubts
injuries. But the patients with AIDS can survive
for a longer period if they are taking immediate
measures to control the replication of virus.
Many researches are in progress to find the
vaccine for AIDS. Recently American researcher
found that certain antibodies resist the HIV virus.
BIBLIOGRAPHY.
1. Marlow DR, Redding AD. Text
book of Pediatric nursing. 6th
ed. Philadelphia: WB Saunders
. company; 2001. p. 1163-5.
2. Hockenberry MJ. Wong’s
10. essentials of Pediatric
nursing.7th ed. St Luis: Mosby
publications; 2007. p. 435-7.
3. Suraj Gupte. The short textbook
of pediatrics. 9th ed. New Delhi:
Jaypee Brothers Medical
Publishers; 2001. p. 387-9.

INDIAN ACADEMY COLLEGE OF NURSING

 SUB: CHILD HEALTH NURSING

MICRO TEACHING LESSON PLAN

ON
TOPIC: AIDS

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