Which is the discoloration of the skin resulting from poor circulation or inadequate oxygenation of the blood. A condition that can cause this symptom is called Tetralogy of fallot TOF. TOF is the combination of four different heart defects and the structures involved are: pulmonary valve stenosis (a narrow opening that slows blood flow), a displaced aorta, a ventricle septal defect VSD, and abnormal enlargement of the right ventricle. The severity of the symptoms are directly related to the amount of blood flow to the right ventricle thus affecting normal blood flow through the heart. TOF is usually is diagnosed after a baby is born, often after birth they have episodes of “turning blue” or cyanosis during feeding just like the baby did in the initial post. Although TOF is a congenital heart defect, if corrected, people go on to live healthy and normal lives. 2)tructural heart disorders refer to the defects within the heart. Structural heart disorders can be present at birth or develop over time with aging, infection, or injury. Valvular heart disease is the most common forms of structural heart disease. Valvular heart disease is when any valve in the heart is diseased or has been damaged. Another type of structural heart disorder is atrial septal defect. This occurs when a baby is born with a hole in his/her heart [1]. Heart arrhythmias are considered functional disorders of the heart. They can cause the heart to beat quickly or too slowly. Heart failure is another form of a functional heart disorder. The most common cause is high blood pressure and heart attack [2]. “Pretty much the same anyway.” I would tell my fellow nursing student that sodium chloride and potassium chloride are not the same. Sodium chloride does not have the potential to kill the patient. However, potassium chloride does have the potential to kill the patient. Administering too high of a dose of potassium chloride or administering it too quickly can both cause the patient to go into cardiac arrest and die [3]. I would tell my fellow nursing student he needs to be certain which form of chloride is in each syringe before administering it to the patient.