I have 2002 Nissan altima that is running rough it doesn't shift smoothly like it used to and its an automatic tranny. Do you think a tranny tune up should do the trick I mean the car does have 190,000 plus miles on it but other than that no problems ever so I def got my moneysd worth out of it but want to keep it running until it drops.

There is no such thing as a "tranny tune up."
If you mean a trans service, like with fluid and filter change, while those may need serviced, that won't do anything for your engine concern (running rough).
If you don't know when it was last done, inspect or replace the plugs with O.E. replacements. Inspect the air filter. Replace if necessary.
Now would be a good time to have your fuel filter replaced if it's also old, and have the injection and air induction system professionally cleaned. (Only the pros can get the best cleaners and have the necessary tools to attach it to your injectors)
If that takes care of the rough running problem, it will possibly take care of the shifting problem, too.