A nurse is preparing to administer a loading dose of esmolol 500 mcg/kg IV bolus given over 1 min to a client who weighs 176 lb. Available is esmolol injection 10 mg/mL. How many mL should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Calculation: Convert the client's weight from pounds (lbs) to kilograms (kg): Formula: Weight in kg = Weight in lbs / 2.2 lbs/kg = 176 lbs / 2.2 lbs/kg = 80 kg Calculate the total loading dose of esmolol needed in micrograms: Ordered dose: 500 mcg/kg Client's weight in kg: 80 kg Formula: Total dose (mcg) = Ordered dose (mcg/kg) × Client's weight (kg) = 500 mcg/kg × 80 kg = 40000 mcg Convert the total dose from micrograms to milligrams: Conversion factor: 1 mg = 1000 mcg Formula: Total dose (mg) = Total dose (mcg) / 1000 mcg/mg = 40000 mcg / 1000 mcg/mg = 40 mg Determine the concentration of the available esmolol injection: Available concentration: 10 mg/mL Calculate the volume of esmolol to administer: Formula: Volume to administer (mL) = Desired dose (mg) / Concentration (mg/mL) = 40 mg / 10 mg/mL = 4 mL