Hormone replacement therapy

A 55-year-old woman is complaining of right upper quadrant pain for the past 5 hours. She said she has had two or three similar episodes in the past; however, they only lasted 1 hour, and the pain was not as severe as with this episode. She thought the prior episodes were due to heartburn, and she has taken over-the-counter antacids with some relief but this time she has not had relief. This episode is rated as an 8 out of 10 scale (0 no pain, 10 severe pain).

The pain is constant and does not radiate.

She says the pain started a few hours after she had lunch (states she ate a fast-food burger). She feels nauseous but has not vomited. She has been getting chills but also feels sweaty. She feels warm but does not know if she has a fever as she has not checked her temperature. Past medical history: type 2 diabetes mellitus and dyslipidemia. Medications: metformin 1,000-mg 1 tablet twice a day; atorvastatin 10-mg 1 tablet a day; and estrogen/progestin hormone replacement therapy 0.3-mg/1.5-mg 1 tablet a day. Social history: does not smoke or drink alcohol; works as a cashier in a grocery store, is married, and has no children. Vital signs: temperature 101.0° F, heart rate 110 beats per minute, respiratory rate 20 breaths per minute, blood pressure 140/80 mmHg, body mass index 31 kg/m2. Answer the following questions pertaining to this case.