Which finding indicates the beginning of salicylism in a client taking aspirin for arthritis?

The beginning of salicylism, a condition resulting from aspirin toxicity, is indicated by the presence of tinnitus. Tinnitus refers to a ringing or buzzing in the ears, which occurs as a side effect of elevated salicylate levels in the bloodstream. This is a key sign to monitor in patients taking aspirin, as it typically manifests when the drug concentration nears toxic levels, differentiating it from common side effects.

Gastric distress is a frequent side effect of aspirin; however, it does not specifically indicate salicylism. Oliguria, or decreased urine output, and excessive bruising can arise from various other causes, including other medications and medical conditions, and are not definitive indicators of aspirin toxicity. In contrast, tinnitus serves as a clear signal for healthcare providers to assess the patient's salicylate levels and consider adjusting the dose or discontinuing the medication to prevent more serious complications.