Author Question: The Dysphagia Outcome and Severity Scale (DOSS) is used to determine the nutrition prescription for ... (Read 45 times)

colton · **on:** Aug 21, 2018

The Dysphagia Outcome and Severity Scale (DOSS) is used to determine the nutrition prescription for a patient. Discuss this scale and how it corresponds to the level of dysphagia diet that is recommended.

What will be an ideal response?

Question 2

Do you feel that Mrs. Maney may benefit from enteral feeding? What guidelines would you use to make this decision? Outline a nutrition therapy regimen for her that includes formula choice, total volume, and goal rate.

What will be an ideal response?

Heffejeff · **Reply #1 on:** Aug 21, 2018

Answer to Question 1

The DOSS is a simple, easy-to-use 7-point scale developed to systematically rate the functional severity of dysphagia based on objective assessment. Its results are used to make recommendations for diet level, independence level, and type of nutrition.
The lowest level represents the most severe dysphagia, and the level increases as functional ability and independence increase.
The levels correspond to the type of diet recommended (normal diet, modified diet, or non-oral diet).

Answer to Question 2

Yes, Mrs. Maney would benefit from enteral feeding since she is consuming < 5 of her meals and consumed < 27 of her energy needs prior to admission
ASPEN guidelines should be used to make this decision; since she is malnourished and critically ill at admission
Formula choice: Two-Cal HN (high-protein formula that provides 2 kcal/mL) = 1800 kcal
Total volume: 900 mL
Goal rate: 38 mL/hr
Osmolality of Two-Cal NH is 725 mOsm/kg H2O; therefore, the initial rate should be 20 mL/hr for first 8 hours, then advanced 10 mL/hr every 4 hours until goal rate is reached.