Mr. Santos, a 45-year-old male, presents to the emergency department with complaints of severe epigastric pain, nausea and vomiting. He reports a history of peptic ulcer disease. On physical examination, he appears pale and diaphoretic. His blood pressure is 90/60 Mmhg, heart rate is 110 beats per minute and respiratory rate is 24 breaths per minute. The nurse suspects a complication related to peptic ulcer disease.