MANMOHAN MEMORIAL INSTITUTE OF HEALTH SCIENCES

AFFILIATED TO TRIBHUVAN UNIVERSITY

INSTITUTE OF MEDICINE

SOALTEEMODE, KATHMANDU

Lesson Plan

on

“Vitamins”

Submitted To: Submitted By:

Respected Madam Sangita Thapa

Asso. Prof. Poojan Sharma (Co-ordinator) Roll No: 27

Asso. Prof. Sushma Acharya BNS ,2nd year

Lecturer Anjana Subedi 9th Batch

Lecturer, Sobita Neupane MMIHS

BNS,2nd year Faculties, MMIHS

Submitted On: 2080/02 /12

LESSON PLAN

Subject : Nutrition and dietetics

Unit Name : Nutrient

Topic : vitamins

Date and Time : 2080/02/12 at 1pm

Duration : 60 minutes

Venue : BSC 1st year classroom

No. of students : 40

Level of students : BSC Nursing

Language : English and Nepali

Name of student Teacher : Sangita Thapa

Level of student teacher : BNS 2nd year

Name of supervisor : Lecturer , Anjana Subedi

Lecturer, Radha Paudel ( programme coordinater)

General Objectives:

At the end of the session, all BSC Nursing 1st year student will be able to explain about vitamin

A and D.
S. Specific objectives Content Time Teaching Teaching Evaluation
N learning learning
method media

Greeting
Revision of previous
class
objectives
Topic Introduction
Pre test
5 min Brainstorm PPT
ing
At the end of this
session BSC nursing 1st
year students will be
able to

1 describe deficiencies of Deficiencies of 5 Interactive PPT What are the deficiencies of

vitamin A. vitamin A. minutes lecture Vitamin A?

2 explain Treatment of Treatment of Vitamin 15 Interactive whiteboar What are treatment of

Vitamin A deficiency. A deficiency. lecture d+ PPT vitamin A deficiency ?
minutes
3 describe prevention of Prevention of Vitamin 15 Interactive Pictorial What are the prevention of
Vitamin A deficiency A deficiency. lecture chart vitamin A deficiency?
minutes
4 introduce Vitamin D. Introduction of 5 Interactive Posture+ What is Vitamin D?
Vitamin D. minutes PPT
lecture
5 describe functions of Functions of Vitamin 10minu Interactive Pictorial What are the functions of
vitamins D D. tes lecture chart vitamin D?

Summarization 5 Discussion
minutes
Deficiencies of Vitamin A

I.Respiratory Tract

Vitamin A deficiency also affects the mucus membrane of the nasal passage, it dries up and its cilia
are lost. Normally, cilia present in the nasal passage create barrier for the entry of infection, but in
this condition this is lost. Similarly, other parts of the respiratory tract, such as throat, trachea and
bronchi become rough and dry.

II. Gastrointestinal Tract

The salivary glands dry up, the mouth becomes dry and cracked due to which the individual is
more susceptible to infections caused by organisms. The gastrointestinal tract becomes thick and
dry which causes diminished secretory ability of mucous membranes with the result the tissues are
discarded and cause flat membranes with few villi. Failure of mucous secretion in the mouth may
lead to loss of appetite. This will hinder normal digestion and absorption of nutrients. These
degenerative changes lead to vomiting, diarrhea and weight loss.

III. Skin

Vitamin A deficiency produces changes in the skin texture. The skin becomes dry (xeroderma) and
scaly. The hair follicles are plugged with keratin which develops small, hard, pigmented lumps
follicle which looks like "goose flesh' or "toad skin."
 Treatment of vitamin A deficiency:

Vitamin A Deficiency Treatment protocol according to Nepal Government 2078 B.S

Case 6 months to Children 12 to

below 1 year 59 months

Xeropthalmia, First Day 1,00,000 IU First day 2,00,000 ( first

(first dose) day)
Night blindness,

Bitots spot Second day Second day

1,00,000 IU 2,00,000 IU
keratomalacia

One month Later One month later

1,00,000 IU 2,00,000IU

Measles First day 1,00,000 IU First day 2,00,000 IU

Second day 1,00,000 IU Second day 2,00,000 IU

Prolonged diarrhoea : One dose upon 100,000 IU One dose upon 2,00,000 IU
for 14 days or more diagnosis of diagnosis of
prolonged prolonged
diarrhoea case diarrhoea case

SAM One dose upon 1,00,000 IU One dose upon 2,00,000 IU

diagnosis of diagnosis of
SAM case SAM case
Treatment Schedule for xerophthalmia according to WHO

Timing Dosage

Immediately 2,00,000 IU ( By mouth) above 1 year

1,00,000 IU (By mouth) Between 6-1 yrs.

50,000 IU (By mouth) Below 6 month.

Next day 2,00,000 IU (By Mouth)

Within 1-4 weeks,when deterioration occurs,

every 2- 4 weeks in the persistent kwashiorkor
2,00,000 IU

➢ In case of vomiting and diarrhoea an intramuscular injection of 1,00,000 IU

General Management

➢ Dietary modifications: Including foods rich in vitamin A in the diet is crucial. These include
liver, fish, dairy products, eggs, orange-colored fruits and vegetables (carrots, sweet potatoes,
mangoes), leafy green vegetables (spinach, kale), and fortified cereals.
➢ Vitamin A supplements: In severe cases of deficiency, vitamin A supplements may be
prescribed. These supplements are available in different forms, including capsules, tablets, or
liquid drops. They should be taken as directed by a healthcare professional.

➢ Food fortification: Fortifying staple foods with vitamin A is a public health strategy used in
many countries to prevent and treat vitamin A deficiency. Commonly fortified foods include
cooking oil, sugar, and flour.

➢ Treating underlying conditions: If the deficiency is caused by an underlying health

condition, such as malabsorption disorders or liver disease, addressing and treating the
primary cause is essential. This may involve medications or other specific treatments.

➢ Promoting breastfeeding and nutrition education: Encouraging exclusive breastfeeding for

the first six months of a child's life and providing nutrition education to caregivers can help
prevent and manage vitamin A deficiency in infants and young children.

Prevention

Schedule for Prophylaxis Vitamin A Distribution according to nepal

government 2078 B.S.

Age 6 - 7 baishakh 19-20 April 2- 3 kartik 19 - 20

October

Cap Vitamin A Deworming Cap Vitamin Deworming

A

6 - 11 months 1,00,000 IU 1,00,000 IU

12 -23 months 2,00,000 IU 200mg ( half 2,00,000 200 mg(half

tab.) tab.)

24 - 59 months 2,00,000 IU 400 mg (1 tab.) 2,00,000 400 mg(1 tab.)

➢ Promote breastfeeding

Breast milk is a natural source of vitamin A, and exclusive breastfeeding during the first six months
of a child's life provides essential nutrients, including vitamin A. Encouraging and supporting
breastfeeding helps prevent vitamin A deficiency in infants.

➢ Food fortification

Fortifying staple foods with vitamin A is an effective public health strategy. Many countries fortify
cooking oil, sugar, and flour with vitamin A to ensure a wider population has access to this essential
nutrient. Supporting and advocating for food fortification programs can play a significant role in
preventing deficiencies.

➢ Vitamin A supplementation programs

In some areas with a high prevalence of vitamin A deficiency, vitamin A supplementation programs
are implemented. These programs target vulnerable populations such as young children and
pregnant women, providing them with high-dose vitamin A supplements periodically. These
interventions have been successful in reducing the incidence of deficiency-related health issues.

Nutrition education and awareness

Educating individuals and communities about the importance of a balanced diet, including vitamin
A-rich foods, can raise awareness and promote healthier dietary practices. Nutrition education can
be delivered through schools, healthcare facilities, community programs, and media campaigns.
Consuming a well-rounded diet that includes foods rich in vitamin A is the first line of defense
against deficiency. Encourage the consumption of vitamin A-rich foods such as liver, fish, dairy
products, eggs, orange-colored fruits and vegetables (carrots, sweet potatoes, mangoes), and leafy
green vegetables (spinach, kale). Including a variety of these foods in daily meals helps ensure an
adequate intake of vitamin A.

➢ Addressing underlying health conditions

Certain health conditions, such as malabsorption disorders or liver diseases, can interfere with the
absorption and utilization of vitamin A. Proper diagnosis and management of these underlying
conditions are necessary to prevent vitamin A deficiency.

➢ Prevention of infection

Vitamin A deficiency is often precipitated by a range of infections including measles, diarrhoea

and acute respiratory infection. Studies have documented corneal xerophthalmia, following
episodes of these common infections of childhood. Frequent infections in childrens lead to greater
requirement of vitamin A.These infections need to prevented through immunization.

Vitamin D

Introduction

Vitamin D is a fat-soluble vitamin that plays a crucial role in several important functions within
the body. It is also known as calciferol. It is primarily known for its role in maintaining strong
bones and teeth by facilitating the absorption of calcium and phosphorus. However, it also
contributes to other aspects of health, including immune function, muscle function, and cell
growth.
Functions of Vitamin D

◼ Calcium absorption

One of the main roles of vitamin D is to facilitate the absorption of calcium from the intestines. It
helps maintain adequate levels of calcium in the blood, which is essential for the development and
maintenance of strong bones and teeth. Without sufficient vitamin D, calcium absorption is
impaired, leading to weakened bones and an increased risk of conditions like rickets in children
and osteoporosis in adults.

◼ Bone health

Vitamin D works in conjunction with calcium and other minerals to promote proper bone
mineralization and growth. It helps regulate the balance of calcium and phosphorus in the bones,
ensuring they remain strong and healthy. Adequate vitamin D levels are crucial for maintaining
bone density and reducing the risk of fractures and bone-related disorders.

◼ Muscle function

Vitamin D is involved in maintaining optimal muscle function. It plays a role in muscle contraction
and strength. Inadequate vitamin D levels can lead to muscle weakness, muscle pain, and an
increased risk of falls and fractures, particularly in older adults.

◼ Immune system support

Vitamin D plays a role in modulating the immune system. It helps regulate the immune response
and has been associated with a reduced risk of certain autoimmune diseases and infections. It is
believed that vitamin D helps regulate the expression of genes involved in immune function.
◼ Cell growth and regulation

Vitamin D is involved in the regulation of cell growth and differentiation. It plays a role in
controlling the growth and development of various cells, including those involved in the immune
system, skin, and other organs.

◼ Anti-inflammatory effects

Vitamin D has anti-inflammatory properties, and it may help modulate the inflammatory response
in the body. It can help reduce inflammation associated with various conditions, such as
autoimmune diseases and chronic inflammatory disorders.
Summarization

Vitamin A is a fat-soluble vitamin that supports healthy vision, particularly in low-light

conditions.It plays a vital role in maintaining the integrity of epithelial tissues, such as the skin and
mucous membranes.Vitamin A is necessary for normal growth and development, including bone
growth and reproductive function.It supports a healthy immune system and helps protect against
infections.Food sources of vitamin A include liver, fish, dairy products, eggs, and orange-colored
fruits and vegetables. Management and prevention of vitamin A are dietary modifications, vitamin
A supplement, food fortification, treating underlying conditions. Vitamin D is a fat-soluble vitamin
that helps regulate calcium and phosphorus levels in the body.It promotes the absorption of calcium
from the intestines and helps maintain strong bones and teeth.Vitamin D is synthesized in the skin
through exposure to sunlight (UVB radiation) and can also be obtained from certain
foods.Adequate vitamin D levels are crucial for proper bone growth, muscle function, and immune
system support.etc.

Home Assignment

◼ What are the Functions of Vitamin D?

References

Banshal,S.(2017).Food and Nutrition(3rd ed).krishannagar,Delhi.AITBS publisher, Page No:297-

301

Paudel,Basaula,R.N. (2021).Nutrition And Dietics. Pradarshani Marg, Kathmandu.Akshav

Publication, Page No:43 - 44

Srilakshmi,B.(2016).Nutrition Science (5th ed.).Delhi,india.New Age International (p)

Limited,publishers, Page No:163- 166

Sharma,P. (2019). Food and Nutrition (2nd ed.). New plaza, putalisadak. Samikshya Books center,
Page No: 81 - 86