A nurse manager in a community health clinic is reviewing the medical records of clients who have diagnoses of communicable diseases. Which of the following infectious diseases should the nurse report to the Centers for Disease Control and Prevention?

A. Case manager: A case manager coordinates care for clients with chronic conditions or complex health needs. For a newborn with an atrial septal defect, the case manager can arrange follow-up appointments, provide education to the family about monitoring for symptoms, and ensure access to cardiology services. This referral supports continuity of care and helps prevent complications.

B. Physical therapist: Physical therapy focuses on improving mobility, strength, and motor function. While important for certain conditions, a newborn with an atrial septal defect typically does not require routine physical therapy unless there are additional developmental or musculoskeletal concerns. It is not the primary referral for cardiac follow-up.

C. Occupational therapist: Occupational therapy helps clients develop fine motor skills and perform daily activities. For a newborn with a heart defect, OT is usually not indicated unless developmental delays or feeding difficulties are present. Cardiac management and follow-up are more urgent concerns at discharge.

D. Nurse manager: The nurse manager oversees nursing staff and unit operations rather than providing direct patient follow-up or discharge planning. Referral to the nurse manager does not address the newborn’s ongoing care needs after discharge and is not part of standard interprofessional follow-up for an atrial septal defect.

A. Levothyroxine for hypothyroidism: Levothyroxine is a thyroid hormone replacement that is considered safe in pregnancy. Proper management of maternal hypothyroidism is essential for fetal neurodevelopment, and it does not pose teratogenic risk.

B. Phenytoin for seizure disorder: Phenytoin is an antiepileptic drug associated with fetal hydantoin syndrome, which can cause congenital malformations such as cleft lip, cardiac defects, and skeletal abnormalities. It carries a known risk for teratogenic effects, requiring careful monitoring and potential consideration of alternative therapies.

C. Magnesium oxide for constipation: Magnesium oxide is generally safe for use during pregnancy for the treatment of constipation. It does not have teratogenic effects and is considered appropriate for maternal use when needed.

D. Ferrous sulfate for chronic anemia: Iron supplementation is essential in pregnancy to prevent maternal anemia and support fetal growth. Ferrous sulfate is safe and does not cause congenital malformations, making it an appropriate therapy during pregnancy.