A 43-year-old male client is being evaluated for intractable peptic ulcer disease (PUD). He has a history of recurrent

A 43-year-old male client is being evaluated for intractable peptic ulcer disease (PUD). He has a history of recurrent duodenal ulcers. Last night he awakened at 2:00 am and requested an antacid. This morning after breakfast, he passed a large, dark, liquid stool that tests positive for occult blood. Just before receiving his 11:00 am H2-receptor antagonist, he turns on his call light. When the nurse enters the room, he is lying on his side with his knees drawn up, moaning, and holding his pillow against his abdomen. He is diaphoretic, pale, and breathing rapidly and shallowly. The client states, “It’s never hurt like this before. I feel as though I’ve been stabbed.”