Las Vegas, Nevada
A Comprehensive Clinical Guide for GI Nurses
Incorporating 2025 ACG Clinical Practice Guidelines
Target Audience: Registered Nurses, GI/Endoscopy Nurses, Emergency Department Nurses, Critical Care Nurses
Level: Intermediate to Advanced
Release Date: February 2026 | Expiration Date: February 2029
Disclosures and Course Information........................... 3
Learning Objectives.......................................... 3
Section 1: Overview of GI Bleeding........................... 4
Section 2: Upper GI Bleeding - Pathophysiology............... 7
Section 3: Lower GI Bleeding - Pathophysiology............... 11
Section 4: Clinical Assessment and Risk Stratification....... 14
Section 5: Laboratory and Diagnostic Evaluation.............. 18
Section 6: Hemodynamic Resuscitation and Management.......... 21
Section 7: Endoscopic Intervention and Nursing Role.......... 24
Section 8: Pharmacological Therapy........................... 28
Section 9: Nursing Care Planning and Documentation........... 31
Section 10: Case Studies..................................... 34
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1. Laine L, Barkun AN, Saltzman JR, et al. ACG Clinical Guideline: Upper Gastrointestinal and Ulcer Bleeding. Am J Gastroenterol. 2025;120(1):30-56.
2. Strate LL, Gralnek IM. ACG Clinical Guideline: Management of Patients with Acute Lower Gastrointestinal Bleeding. Am J Gastroenterol. 2023;118(2):208-231.
3. Garcia-Tsao G, Abraldes JG, Berzigotti A, Bosch J. Portal Hypertensive Bleeding in Cirrhosis: Risk Stratification, Diagnosis, and Management: 2016 Practice Guidance by the American Association for the Study of Liver Diseases. Hepatology. 2017;65(1):310-335. (Updated 2024)
4. Laine L, Jensen DM. Management of patients with ulcer bleeding. Am J Gastroenterol. 2012;107(3):345-360.
5. Villanueva C, Colomo A, Bosch A, et al. Transfusion Strategies for Acute Upper Gastrointestinal Bleeding. N Engl J Med. 2013;368(1):11-21.
6. HALT-IT Trial Collaborators. Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial. Lancet. 2020;395(10241):1927-1936.
7. Barkun AN, Almadi M, Kuipers EJ, et al. Management of Nonvariceal Upper Gastrointestinal Bleeding: Guideline Recommendations From the International Consensus Group. Ann Intern Med. 2019;171(11):805-822.
8. Sung JJ, Chiu PW, Chan FKL, et al. Asia-Pacific working group consensus on non-variceal upper gastrointestinal bleeding: an update 2018. Gut. 2018;67(10):1757-1768.
9. Oakland K, Chadwick G, East JE, et al. Diagnosis and management of acute lower gastrointestinal bleeding: guidelines from the British Society of Gastroenterology. Gut. 2019;68(5):776-789.
10. Stanley AJ, Laine L. Management of acute upper gastrointestinal bleeding. BMJ. 2019;364:l536.
11. Rockall TA, Logan RF, Devlin HB, Northfield TC. Risk assessment after acute upper gastrointestinal haemorrhage. Gut. 1996;38(3):316-321.
12. Blatchford O, Murray WR, Blatchford M. A risk score to predict need for treatment for upper-gastrointestinal haemorrhage. Lancet. 2000;356(9238):1318-1321.
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