Which of the following is a manifestation of vaso-occlusive crisis in a client with sickle cell anemia?

Vaso-occlusive crisis in sickle cell anemia occurs when sickled red blood cells block blood flow in the microcirculation, leading to ischemia and pain in affected areas. Hematuria, which is the presence of blood in urine, can occur during a vaso-occlusive crisis due to kidney ischemia from the blocked blood flow. The renal papilla, which is where urine is concentrated, can become necrotic or damaged when blood supply is compromised, resulting in bleeding into the urine.

While fatigue, pallor, and jaundice can also be associated with sickle cell anemia, they are not direct manifestations of a vaso-occlusive crisis. Fatigue can stem from chronic anemia and the overall effects of sickle cell disease, pallor is a sign of anemia, and jaundice is related to hemolysis of sickle cells. Therefore, recognizing hematuria as a specific manifestation of vaso-occlusive crisis is crucial in identifying acute complications in patients with sickle cell anemia.