Final answer:
Immediate medical management for the patient includes rehydration, electrolyte correction, and administration of antiemetic drugs such as ondansetron. Long-term care involves modifying chemotherapy and consistent monitoring to manage symptoms and prevent complications.
Step-by-step explanation:
The most appropriate management for a 49-year-old female with a history of esophageal adenocarcinoma undergoing chemotherapy, who is now presenting with poorly controlled nausea, vomiting, fatigue, and volume depletion, includes immediate rehydration, correction of electrolyte imbalances, and antiemetic therapy. Rapid intravenous fluids should be administered to address dehydration. Electrolytes, such as potassium and sodium, should be monitored and corrected as needed. Additionally, antiemetic medications, such as ondansetron (brand name Zofran), can be used to control nausea and vomiting. As the patient is undergoing chemotherapy, it's essential to manage these symptoms to allow continued cancer treatment. For long-term management, adjusting the chemotherapy regimen and supportive medications may be considered to better handle emesis. Nutritional support and monitoring for possible complications such as aspiration pneumonia should also be part of the management plan.