A 57-Year-Old Woman Receiving Chemotherapy for Stage IV Hodgkin Lymphoma

question 548

Multiple Choice

A 57-year-old woman receiving chemotherapy for stage IV Hodgkin lymphoma has severe nausea, vomiting, and general malaise.  Her last bowel movement was yesterday, and she has had crampy abdominal pain on and off since the vomiting began.  The patient's second cycle of chemotherapy ended 3 days ago.  Her temperature is 36.7 C (98 F) , blood pressure is 109/68 mm Hg, pulse is 88/min, and respirations are 18/min.  Pulse oximetry reading is 95% on room air.  BMI is 18 kg/m².  Physical examination shows dry mucous membranes and enlarged cervical lymph nodes.  The chest is clear to auscultation.  Mild epigastric tenderness is present on abdominal palpation, but there is no guarding or rebound.  Laboratory studies are as follows: Intravenous fluids are started.  Which of the following is the best next step in the management of this patient?

• A)Anticholinergic agent
• B)Broad-spectrum antibiotics
• C)Dopamine antagonist
• D)Motilin receptor agonist
• E)Opioid antagonist
• F)Serotonin receptor antagonist

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