A nurse is observing a newly licensed nurse who is performing a focused skin assessment on a client who reports a skin condition. Which of the following questions by the newly licensed nurse requires intervention?

Choice A reason:
The lack of insulin production by the pancreas is related to diabetes mellitus, not Addison's disease. Insulin is a hormone that regulates blood sugar levels, and its deficiency leads to diabetes, not Addison's disease.

Choice B reason:
The overproduction of growth hormone by the pituitary gland leads to conditions such as acromegaly or gigantism, depending on the age at which the hormone levels become elevated. It is not related to Addison's disease, which involves the adrenal glands, not the pituitary gland.

Choice C reason:
The overproduction of parathormone by the parathyroid glands leads to hyperparathyroidism, which can cause a variety of symptoms including bone pain, kidney stones, and abdominal pain. This condition is not related to Addison's disease.

Choice D reason:
Addison's disease is indeed caused by the lack of production of hormones by the adrenal glands, particularly cortisol and aldosterone. Aldosterone helps to maintain blood pressure and the balance of sodium and potassium in the blood. When the adrenal glands do not produce enough aldosterone, it can lead to symptoms such as low blood pressure and salt cravings, which are characteristic of Addison's disease.

Choice A reason:
Using an antibiotic ointment is not typically recommended as a preventive measure for skin integrity during radiation therapy. Antibiotic ointments are used to treat bacterial infections, and their use should be directed by a healthcare provider if an infection is present or there is skin breakdown.

Choice B reason:
It is important not to apply heat to the area of irradiation as heat can increase skin irritation and the risk of burns in the treated area. Patients undergoing radiation therapy are advised to avoid heat sources, including heating pads, hot water bottles, and direct sunlight, to prevent further damage to the skin.

Choice C reason:
Lubricating the skin with hypoallergenic lotion can help maintain skin integrity by keeping it moisturized. However, it is crucial to use lotions that are free of metals, alcohol, perfumes, and dyes, as these can react with radiation and cause skin irritation. Lotions should be applied after radiation therapy sessions and not immediately before treatment.

Choice D reason:
The instruction not to wash the area of irradiation is incorrect. It is essential to keep the skin clean to reduce the risk of infection. Patients should gently wash the irradiated area with lukewarm water and mild soap, and pat the area dry with a soft towel. They should avoid scrubbing or using harsh soaps that can irritate the skin.