A nurse is providing teaching to a client who is planning on becoming pregnant about the changes she should expect. Identify the sequence of maternal changes. Order from the first in appearance to last.

The correct sequence of maternal changes from first to last is: Amenorrhea (A) – This is usually the first sign of pregnancy, occurring due to increased progesterone levels and the absence of a menstrual period. Goodell’s sign (B) – This refers to the softening of the cervix, which typically occurs around 6-8 weeks of pregnancy due to increased vascularization. Quickening (C) – This is the first perception of fetal movement by the mother, usually felt between 16-20 weeks of pregnancy. Lightening (D) – This occurs late in pregnancy (around 37-40 weeks) when the fetus descends into the pelvis in preparation for birth. So, the correct order is: A → B → C → D.