weight, age, gender, physiological factors, pathological factors, generic factors, immunological factors, psychological factors, environmental factors, drug tolerance, cumulative effect Signs of ___________________ include fatigue, drowsiness, hunger, anxiety, headache, cold or clammy skin, shaking, lack of coordination, increased heart rate, increased blood pressure, numbness or tingling of the mouth/tongue/lips, confusion, rapid and shallow respirations, or even seizure. Some drugs affect the ___________ directly (across the blood brain barrier) or alter electrolyte or glucose levels. Signs and symptoms of neurological effects include confusion, delirium, insomnia, drowsiness, hyperreflexia, hyporeflexia, bizarre dreams, hallucinations, numbness, tingling, or paresthesia. Nurses use the _____________________, a decision-making, problem-solving, process to provide efficient and effective care. The key elements include assessment, nursing diagnosis, planning/implementation, and evaluation. Application of it with drug therapy ensures the patient receives the best, safety, most efficient, scientifically-based, holistic care.