Respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Jessica Rincon St. Thomas University NUR 417 AP2 Prof. Yedelis Diaz 10/25/2022  Role of Nurses in Disease Prevention and Health Promotion in Older Adults Healthy aging and health promotion behaviors among older adults are strongly related to self-efficacy (Wu & Sheng, 2019). However, most older people struggle with self-efficacy due to economic, social, and environmental factors, leading to poor health outcomes. From this perspective, nurses have the primary role of promoting self-efficacy among older adults. One of the strategies to achieve this outcome is advocacy. According to Lecture Notes (Slide 28), older adults are able to continue to control their lives with the help of nurses’ advocacy.  For instance, nurses can advocate for the allocation of more resources toward social support programs for older adults. Wu & Sheng (2019) argue that social support from friends and neighbors of older adults is more impactful on their healthy aging and self-efficacy compared to family support. Hence, nurses should be at the forefront in fighting for adequate resources for such programs as a way of disease prevention and health promotion in older adults. Nurses should also make recommendations and encourage older adults they interact with to join available social support programs within their communities. I make such recommendations at work every time I see an older adult receiving little support from family due to the positive health outcomes I have noticed in those that have similar characteristics but have benefited from being part of such programs. Screening/Preventive Procedures for Older Adults Caring for older adults is often complex due to comorbidities and concurrent factors that influence their health outcomes. This makes preventive or screening procedures critical in caring for them. Some of the procedures include screening for sensory impairments, screening for functional impairment, and fall-risk assessment (Seematter-Bagnoud & Bula, 2018). Screening for sensory impairments mainly involves assessing visual and hearing abilities, as these factors rank high on geriatric impairments. Sensory impairments have adverse implications on cognitive functioning, psychological well-being, and fall risks (Seematter-Bagnoud & Bula, 2018). Screening for functional impairment assesses the ability of the older adult to perform usual day-to-day activities, predict future functional trajectory and obtain prognosis information. Lastly is fall risk assessment, which is performed for effective preventive interventions. According to Seematter-Bagnoud & Bula (2018), one in ten older adults have significant injuries every year as a result of falls. These injuries pose a serious threat to their functional independence, which, in turn, impedes self-efficacy and healthy aging.  Common End-of-life Documents Nurses must Familiarize Themselves with Powe.

1. Respond to at least two of your peers by extending,
refuting/correcting, or adding additional nuance to their posts.
Jessica Rincon
St. Thomas University
NUR 417 AP2
Prof. Yedelis Diaz
10/25/2022
Role of Nurses in Disease Prevention and Health Promotion in
Older Adults
Healthy aging and health promotion behaviors among older
adults are strongly related to self-efficacy (Wu & Sheng, 2019).
However, most older people struggle with self-efficacy due to
economic, social, and environmental factors, leading to poor
health outcomes. From this perspective, nurses have the primary
role of promoting self-efficacy among older adults. One of the
strategies to achieve this outcome is advocacy. According to
Lecture Notes (Slide 28), older adults are able to continue to
control their lives with the help of nurses’ advocacy.
For instance, nurses can advocate for the allocation of more
resources toward social support programs for older adults. Wu
& Sheng (2019) argue that social support from friends and
neighbors of older adults is more impactful on their healthy
aging and self-efficacy compared to family support. Hence,
nurses should be at the forefront in fighting for adequate
resources for such programs as a way of disease prevention and
health promotion in older adults. Nurses should also make
recommendations and encourage older adults they interact with
to join available social support programs within their
communities. I make such recommendations at work every time
I see an older adult receiving little support from family due to
the positive health outcomes I have noticed in those that have
similar characteristics but have benefited from being part of

2. such programs.
Screening/Preventive Procedures for Older Adults
Caring for older adults is often complex due to comorbidities
and concurrent factors that influence their health outcomes.
This makes preventive or screening procedures critical in caring
for them. Some of the procedures include screening for sensory
impairments, screening for functional impairment, and fall-risk
assessment (Seematter-Bagnoud & Bula, 2018). Screening for
sensory impairments mainly involves assessing visual and
hearing abilities, as these factors rank high on geriatric
impairments. Sensory impairments have adverse implications on
cognitive functioning, psychological well-being, and fall risks
(Seematter-Bagnoud & Bula, 2018). Screening for functional
impairment assesses the ability of the older adult to perform
usual day-to-day activities, predict future functional trajectory
and obtain prognosis information. Lastly is fall risk assessment,
which is performed for effective preventive interventions.
According to Seematter-Bagnoud & Bula (2018), one in ten
older adults have significant injuries every year as a result of
falls. These injuries pose a serious threat to their functional
independence, which, in turn, impedes self-efficacy and healthy
aging.
Common End-of-life Documents Nurses must Familiarize
Themselves with
Power of attorney is a common end-of-life document nurses
must familiarize themselves with when caring for older adults.
This is a document that identifies the agent to make health care
decisions on behalf of a person when it comes to a point that
they are unable to (Lecture Notes, Slide 22). Another important
document is Do not resuscitate (DNR). According to Bloomer et
al. (2018), the document gives care providers guidelines on
what to do during the last stages of an older adult’s life, such as
in the event of a cardiac arrest or when the heart stops beating.
Lastly, these documents or wishes can be included in a general
one referred to as advance directives. Advance directives are
instructions written when the patient is competent enough to

3. make decisions and communicate (Douplat et al., 2019). Nurses
then rely on such directives to provide care when the patient is
in a vegetative state. The importance of knowing these
documents for nurses is for ease of decision-making during end-
of-life care, which is usually characterized by many
complexities.
References
Bloomer, M. J., Botti, M., Runacres, F., Poon, P., Barnfield, J.,
& Hutchinson, A. M. (2018). Communicating end-of-life care
goals and decision-making among a multidisciplinary geriatric
inpatient rehabilitation team: A qualitative descriptive study.
Palliative medicine,
32(10), 1615-1623.
Douplat, M., Berthiller, J., Schott, A. M., Potinet, V., Le Coz,
P., Tazarourte, K., & Jacquin, L. (2019). Difficulty of the
decision‐making process in emergency departments for
end‐of‐life patients.
Journal of evaluation in clinical practice,
25(6), 1193-1199.
Lecture Notes. (n.d.).
Chapter 7: Socioeconomic and Environmental
Influences.
Seematter-Bagnoud, L., & Büla, C. (2018). Brief assessments
and screening for geriatric conditions in older primary care
patients: a pragmatic approach.
Public health reviews,
39(1), 1-13.
Wu, F., & Sheng, Y. (2019). Social support network, social
support, self-efficacy, health-promoting behavior and healthy
aging among older adults: A pathway analysis.
Archives of gerontology and geriatrics,

4. 85, 103934.
Daniela Abreu Abreu
St Thomas University
NUR 417
Instructor: Yedelis Diaz
Date: 10/25/2022
Health
Promotion and Disease Prevention
Nurses are the middlemen for health promotion and the
implementation of health promotion, health protection, and
preventive services. Nurses are trained to treat each patient with
an individualized approach by creating a plan that caters to that
patient’s healthcare needs. Education is a key component of the
care plans that are implemented both formally in health
promotion classes and informally during health care visits.
Nurses are up to date with the latest recommendations and will
work with older clients in deciding what health behaviors they
would like to engage in.
As a nurse working at an outpatient endoscopy center, most of
my work involves health promotion and disease prevention of
colon cancer and other gastrointestinal diseases. Older adults
often come into the facility in a bad mood due to the time they
spent preparing for the procedure. Colonoscopies require 24-
hour fasting and a solution that cleanses the colon. Those
solutions usually are not tasteful and make the patient go to the

5. restroom nonstop. Therefore, by the time the patient comes into
the surgery center for the procedure, they are hungry and
sometimes still nauseous from the colon prep solution. This
horrible experience usually makes clients not want to ever come
back to get their colon checked but we have to educate them on
the importance of coming back when the doctor recommends
them too. We also educate them on signs and symptoms that
should prompt them to visit their gastroenterologist if they do
arise.
Colorectal cancer screenings are recommended at age 50 for
everyone. As per the CDC, screening can prevent colorectal
cancer by allowing the removal of precancerous polyps before
they develop into cancer. If everyone aged 50 and older were
screened regularly, as many as 60 percent of deaths from
colorectal cancer could be prevented (CDC 2019). When
detected early and treated promptly, the five-year survival rate
is 90 percent.
Another screening recommended for older adults is screening
for breast cancer in women aged 40 to 64. This population of
women accounted for 61 percent of all breast cancer cases.
Mammography screening is a valuable early detection tool
because it can identify breast cancer at an early stage, usually
before physical symptoms or complications develop, and reduce
mortality (CDC 2019). Breast cancer screening cannot prevent
breast cancer, but it can help find breast cancer early when it is
easier to treat. It is important to make sure your client knows
which breast cancer screening tests are right for them, and when
they should have them.
All women are at risk for cervical cancer, and it mainly affects
women over age 30. Long-lasting infection with certain types of
human papillomavirus (HPV) is the main cause of cervical
cancer. Pap smears and HPV screening tests can help early
detection of cervical cancer. It is recommended that women 30-
65 years of age get checked. By age 65 or older, if you have had
normal results for several years, the doctor may tell you it is no
longer necessary to screen for cervical cancer.

6. Nurses can guide caregivers and patients nearing the end of life
by educating them on the three most common End-of-life
documents: DNR, Living Will, and Advanced Health Directives.
A DNR order is executed by a competent person indicating that
if heartbeat and breathing cease, no attempts to restore them
should be made and it must be signed by a Physician, Nurse
Practitioner, or patient (state law dependent). A Living Will
directs those extraordinary measures not to be used to
artificially prolong life if recovery cannot reasonably be
expected. These measures may be specified by patients or
witnesses (state law dependent). Lastly, are the Advance Health
Directive. This document explains a person's wishes about
treatment in the case of incompetency or inability to
communicate. Often used in conjunction with a Health Care
Proxy or Power of Attorney (Meiner, S.E., Yeager, J.J., 2019).
References
Centers for Disease Control and Prevention, AARP, American
Medical Association. Promoting Preventive Services for Adults
50-64: Community and Clinical Partnerships. Atlanta, GA:
National Association of Chronic Disease Directors; 2019.
Meiner, S., & Yeager, J. J. (2019). Gerontologic nursing(Fifth
ed.). St. Louis, MO: Elsevier.