4.7 engine with 60k miles is starting to idle very rough. on 2006 Dodge Ram 1500

Sometimes even dies. Any suggestions? Also:
Probably not related, but AC fan is getting noisy (especially on highest setting) and less effective. Loose set screw?

Asked by for the 2006 Dodge Ram 1500
Need to check to see if the engine is using any coolant, I have seen a lot of 4.7 rough idle/misfire codes being caused by a leaking head gasket, so be sure to check that the coolant is not being used up. Other wise, you need to check the plugs, coils etc to see if the misfire/poor idle is ignition related.
Not sure which A/C fan you mean, the electric fan on the radiator or the blower motor in the dash, but either way, if they are getting noisy, it is most likely a bit involved than a set screw.
Thanks. My truck, for the first time ever, ran a little warm this evening so I'll check the coolant level. Sounded like an extra cooling fan on the radiator kicked on. First time I've ever heard it kick on.
Sure hope it's not a head gasket at 60,000 miles. Never run hot before.

AC/heater fan in the dash is what I was referring to as making a rattling sound at the highest speed adjustment.
Thanks again!