Problem:
You are a medical scribe working in the emergency department. Your patient is a 31-year-old female named Brenda. The following is Brenda's explanation of events leading up to her trip to the emergency department. "About 20 minutes after dinner, I was sitting in the recliner watching TV with my family, and I suddenly had sharp stabbing pains in my chest. I told my husband I thought I was having a heart attack, so he called 911. By the time the ambulance got there, the pain had moved from my chest to between my shoulder blades. It was unbearable, a 12 on a scale of 1-10." Brenda's physical exam showed some tensing of her abdominal muscles and pain when the physician pressed on her stomach on the right side just below the ribs. On a hunch, he asked Brenda if she and her family had eaten a greasy meal for dinner, and a surprised Brenda admitted that they had fried chicken. After the ECG found no abnormalities, the physician ordered a scan of Brenda's abdomen using high-frequency sound waves to visualize her internal organs. Just as expected, Brenda's gallbladder was swollen and contained many small stones. No other abnormalities were found