Sucralfate reduces acid production in the stomach. A nursing student is caring for a patient who is taking sucralfate (Carafate) to treat peptic ulcer disease. The student asks the nurse about the pharmacokinetics of sucralfate. Which statement by the student indicates a need for further teaching?

Choice A reason:
Pulmonary embolism is not a typical complication of a peptic ulcer. While serious, pulmonary embolism is unrelated to the gastrointestinal tract and would not arise from ulceration of the stomach or duodenum. It is therefore not the correct answer to the question posed.
Choice B reason:
Bleeding is the primary clinical manifestation of greatest concern with a peptic ulcer. Ulcers can erode into blood vessels, leading to gastrointestinal hemorrhage, which may present as hematemesis (vomiting blood) or melena (black, tarry stools). Severe bleeding can result in hypovolemic shock and requires immediate medical intervention, such as endoscopic hemostasis, blood transfusions, or surgery. This makes bleeding the most critical concern among the options listed.
Choice C reason:
Bowel obstruction can occur as a complication of peptic ulcer disease but is less common compared to bleeding. It arises from scarring or swelling near the pylorus, leading to gastric outlet obstruction. While serious, it is not the most frequent or immediate concern in the context of peptic ulcers.
Choice D reason:
Hepatomegaly, or enlargement of the liver, is unrelated to peptic ulcer disease. This symptom is typically associated with liver conditions such as cirrhosis, hepatitis, or cancer, and does not result from ulcer pathology.

Choice A reason:
Elevated triglycerides are a concern and are associated with an increased risk of coronary artery disease, but they are not as strong a predictor of coronary atherosclerosis as elevated low-density lipoprotein (LDL) levels. Triglycerides contribute to the overall lipid profile and can indicate metabolic issues, but LDL is more directly linked to plaque formation in arteries.

Choice B reason:
Elevated high-density lipoprotein (HDL) is generally considered beneficial and protective against coronary artery disease. HDL helps remove cholesterol from the bloodstream and arterial walls, transporting it to the liver for excretion. Therefore, elevated HDL is not concerning and is actually desirable.

Choice C reason:
Elevated low-density lipoprotein (LDL) is the most concerning when considering the risk of coronary atherosclerosis. LDL is known as "bad cholesterol" because high levels can lead to the buildup of plaque in the arteries, increasing the risk of heart attacks and strokes. Managing and reducing LDL levels is a primary goal in preventing and treating coronary artery disease.

Choice D reason:
Elevated cholesterol is a general term that can refer to increased levels of any lipoprotein in the blood. While concerning, it is more important to identify which specific lipoproteins are elevated. Elevated LDL levels, in particular, are more directly related to the risk of coronary atherosclerosis compared to total cholesterol.