A nurse is collecting data from a client who has been admitted with manifestations of paranoia. Which of the following findings should the nurse identify as a risk factor for schizophrenia?

Choice A reason: A decrease in systolic blood pressure of 15 mm Hg after standing could indicate orthostatic hypotension, which is a known adverse effect of amitriptyline. Orthostatic hypotension can lead to dizziness, lightheadedness, and falls, posing a significant risk to the patient's safety. Reporting this finding to the provider is crucial for assessing the need for dosage adjustments or alternative treatments.

Choice B reason: Hypersalivation is not a common adverse effect of amitriptyline. While dry mouth is a more typical side effect, hypersalivation would be unusual and might indicate an unrelated issue or an interaction with another medication.

Choice C reason: Tinnitus, or ringing in the ears, is not typically associated with amitriptyline use. While it can occur as a side effect of some medications, it is not commonly linked to this particular drug.

Choice D reason: A weight loss of 3.6 kg (8 lb) over a 6-month period is not generally considered an adverse effect of amitriptyline. Weight changes can occur with many medications, but significant weight loss should be evaluated in the context of the patient's overall health and other medications they may be taking.

Choice A reason: Delirium is characterized by an acute onset, typically developing over hours to a few days. It is a sudden change in mental status that differs from conditions like dementia, which have a gradual onset. Therefore, gradual onset is not a characteristic finding of delirium.

Choice B reason: Impaired judgment is a common finding in delirium. Clients with delirium often have fluctuating levels of consciousness, attention deficits, and disorganized thinking, all of which can contribute to poor judgment. This cognitive impairment can lead to unsafe behaviors and difficulty in making decisions.

Choice C reason: Difficulty swallowing, or dysphagia, is not typically associated with delirium. Dysphagia is more often related to neurological conditions such as stroke, Parkinson's disease, or other disorders affecting the muscles involved in swallowing. While clients with delirium may have various physical symptoms due to underlying causes, difficulty swallowing is not a direct symptom of delirium itself.

Choice D reason: Slowed, flat speech is not a typical finding in delirium. Clients with delirium may exhibit rapid, incoherent, or disorganized speech due to their altered mental state. Slowed, flat speech is more commonly seen in conditions like depression or certain types of dementia rather than in acute delirium.