The purpose of this book is to help nurses, midwives and health professionals to better understand how the work of clinical laboratories contributes to patient care.  It answers the following questions:

And most importantly:

Retaining its accessible and user-friendly style, the aim of this book remains the same: to provide nurses with as much relevant information as possible about the most commonly requested laboratory rests. This is not a book about laboratory technique - its focus is on the clinical significance of test results, and therefore the patient.  The third edition is more comprehensive in terms of the number of tests discussed, incorporates colour to aid the accessibility, and includes more paediatric content.

Chris Higgins worked for 16 years as a medical laboratory senior office. He now works as a freelance writer, and has written a series of articles for both the Nursing Times and the British Journal of Nursing.

Preface vii

Acknowledgements viii

Part 1 Introduction 1

1 Introduction to Clinical Laboratories 3

2 Some Principles of Laboratory Testing 13

Part 2 Clinical Biochemistry Tests 31

3 Blood Glucose and HbA1c 33

4 Plasma/Serum Sodium and Potassium 54

5 Plasma/Serum Urea and Creatinine; and e-GFR 75

6 Plasma/Serum Calcium and Phosphate 90

7 Arterial Blood Gases 108

8 Plasma/Serum Cholesterol and Triglycerides 134

9 Cardiac Markers Troponin, Creatine Kinase (MB) and Brain Natriuretic Peptide (BNP) 148

10 Tests of Thyroid Function Thyroxine (T4), Triiodothyronine (T3) and Thyroid stimulating hormone (TSH) 160

11 Liver Function Tests: Alanine Transferase (ALT), Gamma Glutamyl Transferase (GGT), Alkaline Phosphatase (AP), Bilirubin and Albumin 176

12 Plasma/Serum Amylase 196

13 Drug Overdose: Paracetamol and Salicylate 205

14 Therapeutic Drug Monitoring: Lithium, Digoxin and Theophylline 215

Part 3 Haematology Tests 225

15 Full Blood Count 1: Red Blood Cell Count, Haemoglobin and Other Red Cell Indices 227

16 Full Blood Count 2: White Cell Count and Differential 243

17 Tests of Haemostasis: Platelet Count, Prothrombin Time (PT), Activated Partial Thromboplastin Time (APPT), Thrombin Time (TT) and D-dimer 255

18 Laboratory Investigation of Anaemia: Serum Iron, Total Iron Binding Capacity, Serum Ferritin, Serum B12 and Folate 274

19 Erythrocyte Sedimentation Rate (ESR) and Plasma C-Reactive Protein (CRP) 290

Part 4 Blood Transfusion Testing 299

20 Blood Group, Antibody Screen and Crossmatch 301

Part 5 Microbiology Testing 323

21 Urine Microscopy, Culture and Sensitivity (M,C&S) 325

22 Blood Culture 339

Part 6 Screening Tests 353

23 Newborn Screening Blood Tests 355

24 Cervical Screening Test 370

25 Dipstick Testing of Urine 384

Glossary of Some Terms used in Laboratory Medicine 395

Abbreviations 400

Appendix: Adult Reference Ranges 402

Alphabetical Index of Tests 405

Index 407