My rig is same miles, although most all rebuilt. That said most of what I did wasn't necessary. Do some larger maintenance...
FYI ~ At approx 240k miles I blew up my 5.3L tinkering in my garage. Tore it down, aside from what I broke engine was like new inside! I'm not a fan of the plastic lifter trays nor the press fit rocker arm needle bearings... but other than those two weak links the engine should run almost forever. That said, wouldn't hurt to compression test it before you invest too much time and money. Otherwise, it's still got decent power and gets similar mileage as always then maybe forego compression test.
Clean up weak points in transmission accessible via service pan and dropping valve body such as changing the steel check balls with the plastic ones. You'll likely have to buy a new separator plate as I'm not sure where to source the paper gaskets otherwise. Total cost maybe $40 although bit intimidating. That said is much easier than you'd think.
Make sure ALL fluids are replaced. Coolant (flush), front diff, rear diff, flush crankcase (do you have any sticky lifters?). Leave AC alone if works fine.
Do a seafoam intake clean, heck maybe do two. Can borescope cylinders after if you're adventurous.
May consider flushing cats. I just did this... worked like magic. Used powder drain cleaner / Sodium Hydroxide
Replace brake hoses if you haven't already. Classic tube has a reasonable deal on direct fitment steel braided for not much more than rubber.
Check fuel pressures to see if pump is holding up. Bosch makes a really sweet drop in pump for cheap that's higher flow, E85 compatible, and really inexpensive if you're feeling adventurous and up to swapping the pump out of the housing, which isn't too hard. I swapped in a AEM one but Bosh is cheaper for similar spec.
https://www.ebay.com/p/849307292
Go through your front end / steering. Check for loose idler or pitman arms. Replace as needed. Same goes for tie rods. FYI Had BAD luck with moog. I like Mevotech TTX stuff. Been off road and ZERO issues with it. Moog lasted for 10k miles and bit the dust.
3M makes a GREAT spray on protectant for frame. I forget name of it, comes in a spray can. I keep handy and spray my frame ANYTIME I'm doing maintenance under the truck. You'll want to get it, and spray up your frame anywhere it's bare.
Do you have 4wd w/ Auto/AWD feature? That's the NP246 TX case. The other cases may have similar issue. But I know the NP246 AWD TX case chews up the rear housing. Get a case saver and or new rear half of the housing and rebuild the case. It's MUCH easier than it sounds. I have a post on it on the forum here.
Run Lucas Injector Cleaner through the fuel system on next four or five tanks consecutively.
Do you have any engine codes? If so list them and would be worth tackling them.
Any quirks with the truck (hard start, steering pulls, squeaks, etc?)
Truth is, if you take care of some of the larger maintenance, the truck will go until you're tired of it or wreck it.