My 2002 screw with a 5.4 has 180000 miles and uses a bit of oil with poor gas mileage. I can hear the valve train a bit, would it be a good idea to check rocker lashes and if they need it tighten them. any help to kind of freshen up the ol' thing would be great.

 

As far as the oil, look for any leaks. Make sure your PCV valve is still good. They are so cheap and easy to change that I would just replace it to be honest.

As far as gas, what is your gas mileage? Did you modify your suspension (lift / lower / level)? Do you have more aggressive tires?

According to http://www.fueleconomy.gov you should be getting 11 mpg city, and 15 mph highway.

 

There is no adjustment on the cam followers.