、。
And on top of that, this woman had the nerve to order a kaedama twice.
Literal
Moreover this woman, 2-times [also-も] kaedama did-[the-nerve-to-しやがった].
しかも 'moreover' opens the line. 替玉 is the stock Japanese ramen-shop term for 'a second (or more) serving of noodles' added to your remaining broth — originally a ramen-shop innovation, now widespread. ~やがる is a rough masculine/insulting auxiliary verb expressing contempt or annoyance toward the subject's action — 'the bastard / the nerve of X to do Y.' This sentence's humor comes from the register clash: the mundane act of ordering extra noodles meeting a harshly contemptuous verb.