phase of perioperative care that begins with the decision to perform surgery and continues until the patient reaches the operating area. It starts if the patient wants to perform the surgery, then continues until the patient reaches the operating area. When a patient is admitted to outpatient surgery or shortly before surgery, time for preoperative assessment, nursing diagnoses, and nursing management evaluation may be limited. It is important to recognize the patient's immediate preoperative needs. However, preparation for surgery is still required by the nursing process. Evaluation: Preoperative care requires a comprehensive evaluation of the patient. Ratings differ based on the severity of the surgery and whether the patient is admitted on the day of surgery or before. Even in the event of an emergency, nurses are required to make every effort to gather as much information as possible about the patient. During a preoperative evaluation nurses evaluate: a preoperative review of laboratory and diagnostic studies, complete blood count, chest x-ray, serum electrolytes, urinalysis, electrocardiogram, blood type and compatibility, and other tests related to the procedure or patient's medical conditions ( examples: prothrombin time, partial thromboplastin time, blood urea nitrogen (BUN), creatinine or other radiographic studies). If the patient does not follow instructions (such as portion sizes/food restrictions) recommended by the nurse, the nurse immediately informs the surgeon. The surgeon then determines whether the patient is at risk for any complications that may occur during/after the surgery. When the surgery is deemed non-urgent, the nurse performs a thorough history and physical exam…half of the paper…and makes sure the call button is within arm's length. Pre-operative checklist: Many patients transported to the operating room are on stretchers. The nurses cover the patient with a blanket and fasten the restraint straps around the patient, thus ensuring privacy, safety and warmth. Before the patient leaves the room, nurses record the following in the patient's medical record: vital signs, weight, preoperative medications administered, procedures performed, whether or not the patient was voided, disposition of valuables and prosthetics, and significant observations . Many hospitals or surgical facilities use a preoperative checklist. This checklist ensures that all patient assessments and procedures are complete prior to surgery. Once the checklist is completed, the patient is prepared to go to the operating room. The operating room staff transfers the patient onto the stretcher and then into the operating room.