Koraima

“The Wanderer

What is she like?
I was told—
she is a
melancholy soul.

She is like
the sun to the night;
a momentary gold.

A star when dimmed
by dawning light;
the flicker of
a candle blown.

A lonely kite
lost in flight—
someone once
had flown.”
― Lang Leav, Love & Misadventure

“Respiratory Nursing   Chronic Obstructive Pulmonary Disease Diagnosis: Ineffective Breathing Pattern related to airflow restriction Desired Outcome: Following intervention, the patient's breathing pattern improves, as evidenced by absence of dyspnea and oxygen saturation >94%, pH >7.35, and PaCO2 <60 mm Hg. Assessments and Interventions Rationales Assess respiratory rate and depth q6h. Restlessness, dyspnea, tachypnea, use of accessory muscles of respiration are signs of respiratory distress, which should be reported. Auscultate breath sounds q6h. A decrease in breath sounds or an increase in wheezes is a sign of respiratory failure. Administer bronchodilator therapy with albuterol metered dose inhalers 2-4 puffs every 4 to 6 hours as needed. Albuterol increase expiratory volume by decreasing airway smooth muscle constriction. Administer ipratropium (Atrovent) 80 mcg, three times per day. Formoterol (Foradil) 12 mcg every 12 hours. Or administer tiotropium (Spiriva) 1 capsule (18 mcg) inhaled once daily by HandiHaler device Inhaled anticholinergics”
― Paul D. Chan MD, Nursing Care Plans: 650 NDA Approved Care Plans

“Closure Like time suspended, a wound unmended— you and I. We had no ending, no said good-bye. For all my life, I'll wonder why.”
― Lang Leav, Love & Misadventure