Infоrmаtiоn: Yоu аre seeing а 75 year old patient with arthritis in clinic today, with new onset stomach pain. She has nausea and vomiting, and an elevated temperature. She is on Celebrex (NSAID) for the arthritis pain, and has been self treating the nausea with ginger ale. The patient tells you this has been going on for 2-3 months. You are now concerned about which of the following issues: