Which of the following should be minimized to reduce central venous pressure?

To reduce central venous pressure (CVP), minimizing straining, retching, and coughing is vital because these activities increase intrathoracic pressure, which directly affects venous return to the heart. When you strain or cough, the pressure in the chest cavity rises, compressing the veins and impeding blood flow back to the heart. This action can lead to an increase in CVP as the volume of blood returning to the heart is momentarily reduced due to the elevated pressure in the thoracic area.

By minimizing these activities, you help maintain a lower thoracic pressure, thereby allowing for more efficient venous return and, ultimately, a reduction in central venous pressure. This distinction is crucial for patients who may already be experiencing conditions that elevate CVP, such as heart failure or fluid overload situations. A better management of CVP can lead to improved cardiac output and overall patient stability.

The other options like rest, exercise, and medication can have varied effects on CVP but do not specifically address the immediate mechanics of how straining and coughing directly impact thoracic pressure and venous return.