Final answer:
For a client with COPD, atrial fibrillation, and gout, a nurse should arrange to monitor the blood levels of Theophylline and Digoxin, as these require careful monitoring to maintain therapeutic levels and avoid toxicity. Allopurinol, Beclomethasone, and Montelukast do not generally require routine blood level monitoring.
Step-by-step explanation:
The home care nurse reviewing the medical record of a new client with chronic obstructive pulmonary disease (COPD), atrial fibrillation and gout should be specifically vigilant about monitoring blood levels for certain medications due to their potential for serious side effects or the need for maintaining therapeutic levels. In this case, the medications that require blood level monitoring are Theophylline, which is used to treat COPD, and Digoxin, which is used for managing atrial fibrillation. Theophylline levels need to be monitored to ensure they are within the therapeutic range and to avoid toxicity. Similarly, Digoxin levels must be monitored closely, as the margin between effective and toxic levels can be very small, and Digoxin has a narrow therapeutic window.
On the other hand, Allopurinol is typically used to manage gout, Beclomethasone is a corticosteroid for asthma and COPD, and Montelukast is a leukotriene inhibitor for asthma; these do not routinely require blood level monitoring. However, monitoring might be necessary if there is a specific clinical indication or the patient is experiencing potential drug-related side effects.