A cerebral aneurysm is a weakening and saccular outpouching of a cerebral artery. This life threatening condition affects approximately 10 million to 15 million Americans annually. Perioperative nurses must be aware of the incidence, clinical manifestations, pathophysiology, and treatments for cerebral aneurysm. This article details the perioperative care of patients undergoing craniotomy for surgical clipping or insertion of an endovascular coil. Although endovascular coiling is a relatively new procedure with unknown long-term results, this treatment option offers patients a minimally invasive alternative to craniotomy with a shorter hospital stay and decreased recovery time.

Normalization of deviance is a phenomenon in which individuals and teams depart from an acceptable performance standard until the adopted way of practice becomes the new norm. This phenomenon is concerning in high‐risk areas of health care because it erodes a safety culture. Additionally, it is inimical to the principles of high reliability—specifically, to the first of the five principles: preoccupation with failure. Although all high‐reliability principles hold relevance to safety, preoccupation with failure describes a consistent alertness to risk and is critical for preventing adverse events, particularly in high‐risk environments such as the OR. This article describes how normalization of deviance and preoccupation with failure cannot coexist and presents ways to mitigate normalization of deviance and bolster high reliability, ultimately making ORs safer for surgical patients.

Peripheral nerve blocks involve injecting local anesthesia near or around a nerve or nerve plexus. This form of anesthesia allows surgeons to perform more complex surgeries and provides extended postoperative analgesia for patients. Patients experience reduced postoperative pain and length of hospital stay and increased satisfaction with the outcome of surgery because they are less likely to experience adverse effects. Use of peripheral nerve blocks in an outpatient setting is becoming more common and has increased the perioperative nurse's patient care responsibilities. The nurse must perform a preblock assessment and assist the anesthesia professional with administration of the block. Major responsibilities of the nurse include identifying and managing potential adverse effects (eg, pneumothorax, toxicity) associated with block administration and patient discharge education.

The purpose of this article is to present an overview of esophageal varices. The causes of esophageal varices and the current treatments are examined. Information is provided regarding surgical and nonsurgical forms of treatment. Various aspects of nursing care are discussed, including the implications involved in the emergency setting, psychological needs, and education for patients and their families.