Human Sexuality

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sexuality definition

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All humans are sexual beings, sexuality is an individual experience epxressed and highly personal phenomenon whose meanings evolve from life experiences. physiologic and psychological and culture factors influence a persons sexuality and leads to a wide range of attitudes and behaviors seen in humans.

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mons pubis

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covers the anterior portion of the symphysis pubis.Protects the pelvis bones especially during coitus ( method of contraception male pulls out before ejaculation.

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Breast

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women have grandular tissue through out breast tissue. men have gradular tissue beneath each nipple a potential site for malignancy. largest portion of the breast is upper outer quadrant of the breast. Majority of tumors are located in the upper outer breast quad.

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menstrual cycle

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sexual intercourse a practice
during the menstrual cycle. the average age is about 12.5 years in the US. but may occur between the ages og 8-16. the most critical factor in successful adapation to menarche is the adolescents level of correct prepardness. cycle length is determined from the first day of menses. once the cycle is established it is usual 29 days but could vary 21-35 days and that would be still normal. flow average is 25-60ml blood loss over 80cc is considered abnormal length 2-8 days but can vary.

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menopause

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is known as that the onset occurs when estrogen levels drop because of cessation of ovarian fuction. Documented when a women does not have a menses for 1 year.

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climacteric=change of life

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refers to the host of psychologic and physical alterations that occur around menopause. exercise, teaching on proper nutrition are critical for overall health.
S/S related related to hormonal changes- mood swings, clinical depression

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premature menopause

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is demonstrated by amenorrha, a sharp decrease estrogen and an increase in follicle stimulating hormone. pemature menopause is treated with estrogen and other forms of premature menopause occur with anorexia, chemotherapy, radiation treatments and oophorectomy, surgical removal of ovaries.

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labia majora

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raised folds of pigmented skin on either side of the vulva cleft they narrow enclosing the vulva cleft. contains sebaceous glands

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Labia minora

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labia minora are skin folds within the labia majora that converge near the anus forming a fourchette. rich in sebacous glands which lubricate and water proof the vulva skin and provide bacterial secrections. sebacous cyct commonly occur in this area. valvovaginitis occurs in this area d/t nerve tactile endings. increases insize at puperty and decreases after menopause d/t estrogen levels.

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clitoris

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located between the labia minora its tissue is erectile. the glands of the clitoris is partly covered by fold of skin called the prepuce or clitorial hood the primary erogenous organ of the women. it secretes smega.

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uretral meatus and paraurethral glands

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located beneath the clitoris.
skenes glands open in to the posterior wall of the urethra. secretions help lubricate the vaginal vestible facilitaing sexual intercourse.

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vaginal vestible

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a boat shaped the sepression enclosed by the labia majora, the vestible contains the vaginal opening (introitus). border between the the external and internal genitals

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hymen

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a thin elastic collar or semicollar of tissue that surrounds the vaginal opening. the hymen surround the opening not covers.

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valvovaginal glands or bartholin's glands

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lie under the consticter musle of the vagina and secrete a thick clear alkaline mucus that enhances the motility of of sperm deposited in the vaginal vestibule.

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perinal body

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a mass of wedge like fibromuscular tissue. between the anus and vagina refered to the perineum. allow stretching and is the area of the episiotomy during chidbirth.

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external genital
penis

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elongated cylindrical structure consiting of the body termed the shaft and aconed shaped end called the glands. the shaft of the penis is made up of the columns of erectile tissue, a pair of corpora cavernosa and a third spongiosum, and enclose by elastic tissue.

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corpus spongiousm

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contains the urethra and becomed the glans at the end of the penis.

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urethra meatus

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a slitlike orifice located at the tip.

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foreskin or prepuce

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a circular fold of skin of skin behinf the glans and covers it

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hypospadis

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uretral meatus may ocur on the ventral aspect of the penile shaft if the corpus spongiosum does not surround the urethra.

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epispadias

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urethral meatus on the dorasal aspect of the shaft.

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scrotum

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pouchlike structure tgat hangs ub front of the anus but behind the penis, each compartment contains a testis. the function of the scrotum is to protect the testes and the sperm by maintaining a temperature lower then that of the body.

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ejaculation

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the penis becomes erect when blood vessels become engorged a consequent of the parasympathic nerve stimulation. If sexual stimulation is forceful and intese enough sudden expulsion occurs through the rhythmic contractions of the penile muscles.

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male menopause

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xxxxxx

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age related sexual changes men and women

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slower sexual arousal for both men and women -major age related in sexual response is timing -longer to become aroused and to complete intercourse - libido may decrease but not disapear -
if an elder man reports loss of sexual desire you should be concerned

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age related sexual changes in women

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increased length of time to become aroused - longer to produce vaginal secretions -labia and uterus do not fully elevate making penetration slightly more difficult. - during organism uterus will contract less frequently but contractions remain vicous like a young women

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enlaged prostate

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Prostate gland encircles the upper part of the urethra and lies below the neck of the bladder. It secretes a thin milkly alkaline fluid, containg a high levels of zinc, calcium, citric acid, and acid phosphate. the fluid protects the perm from the acidic environment from the vagina and male urethra. S/S urinary frequency, nocturia, dribbling, and problems with begining and ending stream, are usually the result of an enlarge prostate,

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dcreased fertility

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xxxx

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side effects of medication and illness on sexual functioning - alcohol

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moderate amounts increase sexual functioning -chronic use decrease -

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side effects of medication and illness on sexual functioning - alpha blockers and narcotics

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inability to ejacluate

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side effects of medication and illness on sexual functioning - amphetamines

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increased sex drive delayed organisum

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side effects of medication and illness on sexual functioning - amyl nitrate

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enhanced orgasm , vasodialtion, fainting

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side effects of medication and illness on sexual functioning - anabolic steriods

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decreased sex drive shrinking of the testicles and infertility in men

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side effects of medication and illness on sexual functioning - antianxiety agents - anticonvaulsants - antidepressants antiherpertensives anti physchotic anihistamines, barbituates, beta blockers, cardiontics diurectics

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decresed sexual desire, orgasmic dysfunction in women - delayed ejactulation, reduced sexual response, delayed or failed ejactulation, painful erection - decresed vaginal lubricaton - erectile failure - ejactulatory failure

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side effects of medication and illness on sexual functioning - cocaine

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increase intensity of sexual desire - with cronic use decrease sexual desire and sexual dysfunction

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gender roles regarding reversal of roles who says with the famliy and who is the bread women

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xxxx

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socioculture factors women to tolerate sex - or encorage to participate in sex- sexual modesty valued - incest is taboo- women in tradition jobs

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xxxxx

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preference contraception - the common methods are based on the following prinicples -

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inhibit ovulation - kill the sperm or reduce motility - prevent the sperm from meeting the egg.

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birth control pill (BCP)

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prevents the women from releasing eggs from ovaries during ovulation - surpresses the follicle stimulating hormone (FSH) & Lutenizing hormone (LH) preventing follicles from maturing - the pill is 99% effective if taken every day - it is safe - women regain fertility as soon as pill is stopped - decreases menstrual flow and durations, cramping, ovualary pain - dereases ovarian cysts and acne - effective in treating endometriosis - disadvantages - must take daily, headaches, NV, water retention, breast tenderness, vaginal yeast infections, depression, mood changes , decress libido, chlamydia infections, increase risk for blood clots in the leg lung heart or brain these risks are more associated in smokers, sedentary overweight women, over 50, high BP, diabetes, high cholesterol, you can become pregnant if you forget a pill, if you do take it as soon as possible and still tke the rest as normally it could mean two in one day. use other precautions till you have been back on track for 7 days.
Extreme caution if you: are over 35 and smoke 15 cigarettes a day, migrains after starting the pill, high BP or diabetes, major surgery that requires immobility for 4 weeks, undiagnosed vaginal bleeding, sickle cell disease, gall bladder disease, cardiac or renal disease, breast feeding, over 50.

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depo provera

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hormone injected every 12 weeks, very effective form of birth control, stop eggs from being released each month, thickens the mucus near the cervix and blocks the sperm, can be used by women who cannot take estrogen, reduce menstrual cramps and anemia, protect against ovarian cysts, protects against endometrial cancer, can use by breastfeeding, starting six weeks after delivery. can be used by women who require medications for seizures.
side effects: irregular intervals between periods, longer menstrual flow, spotting in between periods, no bleeding for months at a time. does not protect from stds

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NORPLANT

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synethic hormonal implant of levonorgestre. set of 6 capsuls or two if using norplant two inserted under the skin of the upper arm. convenient and give continuous longlasting bith control without sterlization.can be used by women who cannot take estrogen, can be used while breast feeding 6 weeks after delivery, side effects: may have difficulty removing the implant, most common side effect is irregular bleeding, irregular intervals between periods, longer menstrual flow, irregular bleeding in between regular periods, no bleeding for months at a time.

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male condom

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barrier method of birth control. use for a method of protection and protection againdt sdt's. condoms contain nonoxynol 9 a spermicidal that not only kill sperm in case the condom leaks or breaks but also is intrumental in reducing the rate of std. failure rate 12% failure rate used correctly is 3%. sheep skin condoms is not effective as not effective in preventing pregnancy or in prevention of std and hiv.

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female condom

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shealth or pouch that lines the the vagina and helps to prevent pregnancy and std's. the ring stays outside the vagina and acts as guide during penetration.

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diaphragms and cervical caps

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a shallow dome shape cup with a flexible ring it fits in the vagina and over the cervix. must be used with a spermicidal cream jelly or foam. comes in many sizes cervical cap comes only in 4 sizes. a new size may be needed after a pergnancy, abd. surgery, a miscarriage or an abortion, after fourteen weeks of pregnancy, a weight gain or loss of 10lbs or more.
may develope frequent bladder infections, urinate before inserting and after intercourse, may be inserted several hours before intercourse may stay in place 6-8 hours after intercourse, do not leave inplace for more than 24 hours.

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intra uterine device (IUD)
a chemical method of birth control

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tow types of IUDs. One ryoe contains tge hormone levonorgestral. the hormone is continuously released into the uterus. another type is covered by copper. the copper iud has a copper wire around the stem & arms of the device. Iud is placed in the uterus. it has 2 threads/strings that lead from the it into the upper vagina. It causes damage to the sperm preventing it from reaching the egg. the iud may stop a fertilized egg from attaching itself to the liningof the uterus. progesteron system - less blood loss and dysmenorrheal. an iud gives very long birth contro: copper 4-8 yrs. pogesterone 2 yrs. convient take out when want to. check strings once a week for the first month then once a month at the end of period. Intended for : women who have at least one child, stable monogamous relationship. do not use an IUD if: more then one sex partner, heavy or painful periods, allergy to copper, STD's such as chlamydia, gonorrhea, PID pelvic imflammatory disease. Side effects: heavy longer and more cramping with period, spotting or light bleeding between periods, women who have std's at increase risk fo pelvic infection, Pid with IUd can lead to problems of getting pregnant. uterus can expell an IUD lead to unplanned pregnancy, can perforate through the uterus, pregnancy may occur, higher risk of misscarriage or tubal pregnancy, effect from of birth control but does not prevent against STD's.

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vasectomy barriers method

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vasectomy is the name of the procedure to close the vans deferens that carry sperm and prevents sperm from being released in the semen, done in the doctor office using a local anesthetic. two tiny incisions are made in the on the scrotum. each tube is pulled out through the incision and a small section is removed. the ends of the tubes are sealed the incisions closed. the procedure takes about 15-30 minutes the pt can go home right away. some mild brusing and swelling for a couple days. vasectomy is very safe however there is a small chance of bleeding, infection and swelling. vasectomy is not efective right away, there may still be sperm in the proximal portions ofthe ducts after the procedure. these will be cleared after 15 ejactulations.A sperm count donme at a lab to insure negative count.Use birth control until you know the results of the test.Vasectomy is meant to be permanent.It is not easy to reverse. in some cases men have been able to have the procedure reversed but the success rate is low. after vasectomy the body will continue to make sperm does not effect the potency. the sperm will enter the tubes but when it reaches the sealed end it will disenegrate.vasectomy is 100% effective rarely do the tubes rejoin and the vasectomy fail

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Tubal ligation

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A surgical technique for women done through a laparoscope procedure closed the fallopian tubes and stops the egg from traveling to the uterus from the ovary. Fallopian tubes are cut burned or blocked with rings bands or clips. surgery is effective immediately. tubla ligations are 99.5% effective birth control.

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emergency contrception pill

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taken in 2 doses 12 hrs apart, best when the first dose is taken with 72 hrs of uprotected vaginal intercourse.
examples: plan B progestrin only) and preven estrogen and progestin). side effects usually taper off one or two days after the second dose has been taken. half the women who take take the combined pill feel sick to their stomachs but only for about 24hrs. up to one out of three women vomit with the combined pills. The risk of N/V is lower with progestin only ECP. breast tenderness irregular bleeding fluid retention dizziness and headaches may also occur.Frequent use of ECPS may cause periods to become regular.

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Bisexuals

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individuals who are attracted to both sexes

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transexual

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gender dysphoria ( strong and persisent feelings of discomfort with ones assigned gender) also known as gender identity disorder. sexual anatomy is not consistent with gender identity their sexual orientation could be heterosexual, homosexual, or bisexual.

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masturbation

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an ongoing love affair that each of us has with ourselfs throught are life time. It is the way we discover iyr erotic feeling and learn about our sexual response. Shared with a partner is a safe alternative to unprotected sex.

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oral genital sex

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is know technically as cunnilingus. It is not free of the potential for STI transmission.

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fantasies

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single partner sex are the most common sexual outlets for men and women single, coupled, heterosexuals gay/lesbian and bisexual persons.

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celibacy

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culture family structure polygamy

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Islamic families from west africa practice polagmy - do not freely admit this in the US. both wifes sometimws live in the same house

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Culture - Terminatiion of pregnancy

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In muslum countries an unmarried women may seek a clandestine abortion because of the consequences of carrying an illegitmate child can be social ostracisum or even death. even if the pregnancy is due to rape the it is not unheard of for women to be killesd if the family discovers that she engaged in sexual intercours outside of marriage and became pregnant.

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culture Contraception

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many muslums may use contraception but so not beleive in sterlization because of it being permanent.Other muslums may not practice contraception because children are highly valued.the role of the women is to bear children.

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Culture touch

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varies in each culture nurses should look for responses of the family to touch and progress accordingly.